MIMOīS APARTOTEL
Giulia de Manuel Antonio S.A.
Telef: (506) 777-0054- Fax: (506) 777-2217
www.mimoshotel.com
E-mail: reservations@mimoshotel.com

Reservation

Name:                                                                                              
Tel:                                                                  
Fax:                                                                 

Check in         /             /                         Check Out       /              /                Pax#
Nights:                                                                                                         $
                                                               Total:                                            $
                                                               16.39% Tax :                               $
                                                               Total:                                            $

PLEASE FILL OUT THIS FORM AND SEND IT BY FAX

International Credit Card Charge Authorization Form

Date(day/month/year):                 /               /                 

1.                                                                                  hereby  authorize
         (as it appears on the credit card)
 
HOTEL MIMOīS to charge my (  ) Visa Card    (  ) Master Card

Credit Card Number (                                                                  )

Expiration Date (             /           /          ) in  the amount of USD $                           

Bank Code (last 3 digit cars id) (                         )

FINAL METHOD OF PAYMENT
   1.Same credit card above                                                           mark whit an x (  )
   2.Cash to the hotel at check in                                                    mark whit an x (  ) 
   3.Travelers cheque at check in                                                   mark whit an x (  )

I have read and accepted the conditions of the reservations and agree to pay the amount here authorized even though I have not signed the original voucher. I agree to pay this amounth in case of NO SHOW or CANCELATION within 15 days prior of the arrival time.

                                               
Credit Cars Holderīs Signature