CREDIT CARD TRANSACTION FORM
Your Credit Card is Safe with LUXURY TRAVEL Co., Ltd
(WWW.LUXURYTRAVELVIETNAM.COM)

   Date : ____/____/_______

   CREDIT CARD NUMBER : ___________________________________________________________

   TYPE :                      VISA          MASTERCARD          AMERICAN EXPRESS           DISCOVER

   EXPIRATION DATE : ____/_____       CVV2 CODE (located on back of card___________________

   NAME ON CREDIT CARD: _______________________________________________________________

   BILL TO ADDRESS : ________________________________________________________________

   ________________________________________________________________________________

   PHONE NUMBER: __________________________________________________________________

   E-MAIL ADDRESS : ________________________________________________________________

   ACCOUNT NUMBER or WEB SITE ADDRESS : ___________________________________________

   AMOUNT TO BE PAID IN US Dollars : $ ________________________________________________

AUTHORIZATION :

   PRINT NAME : _____________________________________________________________________

   SIGNATURE : ______________________________________________________________________

   Notes :____________________________________________________________________________

   __________________________________________________________________________________

   __________________________________________________________________________________

*********************** IMPORTANT ************************

 Please kindly print this form, fill-in your details and fax it back to our Hanoi Office at ++84.4.   3927 4118 Attention Reservation Department

 Address: 05 Nguyen Truong To Str, Ba Dinh Dist. Hanoi, Vietnam

 Opening Hours:
 
 Monday – Saturday: 9.00 am – 6.00 pm
 
 Sunday: 10.00 am – 4.00 pm (reservations only)
 
 Contacts:

 Phone: ++84.4.3927 4120 Fax: ++84.4.3927 4118 Hotline:++84.91.2303096