3rd Party Payment Authorisation Form

City Break Apartments
3rd Party Payment Authorisation Form

3rd Party Payment Authorisation

Personal Information

First Name *

Last Name *

Phone number *

Email Address *

Attach a photo of your Passport or National Identity Card *

Maximum file size: 262.14MB

Attach a photo of the front of the card used for payment ( Only the last four digits need to be visible ) *

Maximum file size: 262.14MB

First and second name of the person checking-in *

Phone of the person checking-in *

Add your booking Reference *

I certify by clicking this box that I authorise ( as the card holder ) the full payment for the reservation with ref above *

No Yes

I certify by clicking this box that the information submitted in this form is true and correct to the best of my knowledge. I further understand that any false statements may result in denial checking into the property
I understand also that by clicking this box I agree with City Break Apartments Terms and Conditions* *

No Yes

Signature *

Clear

If you are human, leave this field blank.

*City Break Apartments Bookings Terms and Conditions

CONTACT DETAILS

Our office is open 7 days a week.
Opening : 08.00 - 20.00

Office: +353 1 443 3920

Email: info@citybreakapartments.com

City Break Apartments
3rd Party Payment Authorisation Form

Personal Information

*City Break Apartments Bookings Terms and Conditions

CONTACT DETAILS

USEFUL LINKS

OTHER PAGES

OUR NEWSLETTER

Contact Details

Useful Links

Other Pages

Our Newsletter

City Break Apartments 3rd Party Payment Authorisation Form

Personal Information

*City Break Apartments Bookings Terms and Conditions

CONTACT DETAILS

USEFUL LINKS

OTHER PAGES

OUR NEWSLETTER

Contact Details

Useful Links

Other Pages

Our Newsletter

City Break Apartments
3rd Party Payment Authorisation Form