CHEQUE PAYMENT CONFIRMATION
Thank you for filling this form and attach a copy of the ID cheque holder. This file must be filled in and signed by the cheque owner.
I, Mister/ Madam ……………………………………….. confirm the cheque payment for the stay of
Mr/Mrs……………………….…………from.........................to...................................
For the following benefits (please check your choice):
o Room
o Breakfast
o City tax (1.5€ per day and per person)
o Extra charge
For an amount of ………………..€
City: ………………………………….. The: ……………......
Cheque holder signature:
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