DS9 Document EFTA00314289

P 4 7 ( Z Hotel Manapany & Spa Thak you for your reservation, we are delighted that you will be joining us. In order to secure you reservation can we kindly ask you to filled out this form and return it by email at the following adress: Your Reservation O Hotel Manapany & Spa Name: Surname: Time of your reservation: from 26 december 2015 to 10 january 2016 Room Category : Deluxe room garden view Rate : 12 835,00 euro + 5% taxe Nights : 16 Your Credit Card Authorization O Mastercard K Visa K American Express Credit Card Number : Expiration Date : Cryptograph : Credit Card Holder's name : Hotel Manapany Cancellation Policy I hereby give Manapany & Spa my authorization to charge my credit card for the quoted reservation bellow whitout cancelling 91 days in advance.. The amount of 12 835 euro will be charged on my credit card. Correspondind at the reservation number R19900 (95790126). I will be responsible for the amount of my bill and I will not contest the charges when I receive my monthly credit card statement. Date : Signature : Hotel Manapany & Spa Tel Fax Email : Anse des cayes, 97133 Saint Barthelemy, FWI www.lemanapany.com EFTA00314289