certified:

services:

info@lizvilla.co.za
tel: +2782 776-0935

Guest Name:		Surname:
Physical Address:
Postal Address:
CONTACT DETAILS
Email:		Mobile:		Telephone:
Arrival Date:		Time:		Depature Date:
PAYMENT (Tick applicable block only)
Official Company Order No:		Faxed on:
Credit Card No:		Expiry Date:
Cash Paid in Bank account:
NB: Original Order Form or Credit Card shall be presented at check in time. One night tariff will be charged for no shows and 20% of daily tariff for cancellation less than two days.
LIZVILLA BANKING DETAILS
Account Name	Lizvilla Guest House	Account No:	12504122 (Current Account)
Bank:	Standard Bank, Pretoria Branch	Branch Code:	010445