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Advance Payment Through Credit Card (Visa/Mastercard)

 

Please complete, sign and fax at: + 977-1-4700898 with Complete information.

Date:....................

Himalayan Bank Limited
Credit Card Centre
Lalitpur, Nepal

Dear Sir,

Authorization for the Payment by credit Card

I would like to pay US$…………… for the Advance of.............................................
to Nepal Mountain Trekking Pvt. Ltd. by VISA / MASTER CARD.

The necessary details for this transaction are as below:

Card Number................................................................................................
Expiry Date ...................................................................................................
Amount ..........................................................................................................
Identification Number.....................................................................................
Billing Address ..............................................................................................

Kindly receive the copy of my credit card (both-side) and the copy of my
identification
along with this Request Letter
(
please fax the photocopy of credit-card both side and your passport for identification)

Thank you for your kind co-operation.
Regards,

Signature of the Cardholder..............................................................................
Name of the Cardholder....................................................................................
Nationality of the Cardholder............................................................................
Passport number................................................................................................
Address (Card holders’)....................................................................................
Telephone.......................................Fax.............................................................
E-mail.................................................................................................................

Confirm me, when you receive this :- By Email or by Fax 

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