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Payment Authorization

Booking Details

Booking Name

Payment Amount (IDR)

Booking Email

Payment Purpose

Payment Details

Cardholder Name

Card Type

Card Number

Expiry Date

C V V

Card Issuer

Cardholder Billing Address

Notes (Optional)

Only for transaction above IDR 1 million

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Cardholder Agreement

As cardholder, I authorize Kumpul Kumpul Villa to charge my card. I understand this is a legal binding agreement and that I maybe required to present my card upon arrival for verification

I have read, understood and agreed

Cardholder Signature