Folio Number

Name
Contact
Address
Mahmud Rt. 01
City/State

:
:
:

08912
Taufik Afdal, Mr
085765648325
:
Jl. Sultan

Rw. 04 No. 20
Tanjungpinang
INA

Pax
Payment
Room Number
Room Rate
Arrival Date
Departure Date

:
:
:
:
:
:

2
CS
#4123
Rp. 550,000
28-Nov-2013
29-Nov-2013
User ID

:KARTIKA
Date
Credits
28-Nov

Transaction

Room Charge
Service Charge Room
Tax Room
29-Nov
Deposit Cash
1,100,000.00

Description

Room Charge 28 29 Nov

Service Charge Room
Tax
DPST #4123 2 N

Charges

Room #4123 2 N
Room #4123
Room #4123
1,300,000.00

Balance

Page 1 of 1

I AGREE THAT MY LIABILITY FOR THIS BILL IS NOT

WAIVED AND AGREED TO BE HELD PERSONALLY LIABLE
IN THE EVENT THAT THE INDICATED PERSON, COMPANY
OR ASSOCIATION FAILS TO PAY ANY PART OR THE FULL
AMOUNT OF THESE CHARGES

1,100,000.00

(200,000,00)

SIGNATURE :

Jalan Industri Raya No. 8 Gunung Sahari Jakarta 10720, Tel: (62-21) 6231 7788 (Hunting), Fax: (62-21) 6231 7799
Website: www.orchadshotel.com