PLEASE FILL OUT FOR EACH RENTER

Cliffs 1-108 PAYMENT Form                                  INVOICE # ________

Note: 

The Renter will see the charge from NY Entertainment Connection Inc.

on the Credit card statement.  If renter pays by check or cashiers check, it must be

received at least 2 weeks ahead of time and within 4 days to hold dates.  

                                                                                                 ( Circle one below)

AMOUNT:_______________________  Paying by   CC      CHECK       CASHIERS CK

 

DATES STAYING: ____________________to______________________

 

NAME:______________________________________________________

 

CREDIT CARD ADDRESS :  (Put full address including street number and zip code)

_________________________________________________________

 _________________________________________________________

 

HOME ADDRESS if different from Credit Card Address:

__________________________________________________________

__________________________________________________________

 

CARD TYPE:  _____________________________________________

(Master Card or Visa Only)

 

CARD NUMBER __________________________________________

 

EXP DATE ________________________________________________

 

Home phone:  ______________________________________________

 

Cell phone:   _______________________________________________

 

Email : ____________________________________________________

 

RENTAL DATES COST DETAILS:

 

_____________________________Through  ______________________________

 

Price per night_________________X  ___________nights  =_________________

 

Plus Transient Tax 7.25%                                                      + _________________                       

 

Plus excise tax 4%                                                                 +  ________________

 

Plus Cleaning Fee                                                                  + _________________

 

                                               TOTAL DUE:                  ______________________

If you input the credit card – please fill this out.

Input date: ________________________________

Approval code: ____________________________

Date settled: ______________________________

Batch # __________________________________

Batch approval code: _______________________