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 imager.class                               Fax: 977-1-4238049
service@alpinenepal.com.np

Date: …………………………………….. Alpine Card Service P/L Durbar Marg, Kathmandu, Nepal

Dear Madam / Sir, Re:Authorization for the Payment by Credit Card I would like to pay USD…………………………………………….………for the purchase of ……………………………………………………………………………………………………………..…………………………………………… to Majestic Mount Everest Trek & Expedition, Merchant
ID No : 0000000000039495 by my Visa /MasterCard.

The necessary details for this transaction

are as below:

Card Number: ……………………………………………………………………………

Card Expiry Date: …………………………………

AmountinFigure: ……………………………………………………………………………………………………………………………

ID Number (Passport): ……………………………………………………………

C/H’s Date of Birth: ……………………………………………………

Statement’s Address: ……………………………………………………………………………………………………………………………

Note: Kindly receive the copy of my credit card (both sides) and the copy of my identification (passport) along with this request letter. Thank you for your kind co-operation. Regards, Signature of the Cardholder: Name of the Cardholder: *Note: Please verify amount

 

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