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

The Manage
Himalayan Bank Ltd.
Thamel, Kathmandu , Nepal .
Subject: Authority to process credit card transaction through Fax.

Dear Sir,
I hereby authorize following merchant to process transactions as detailed below.
Merchant Name : - Angel Tours & Travel Pvt. Ltd.

Merchant No :-

Account No. (NPR):- 001 00993960025

Account No. (USD):-001 00993960017

Branch code: -Karmachari Sanchaya Kosh Building, Thamel.

Name of Bank: - Himalayan Bank Limited.

Sift Code: - HIMANPKA

Tel :- 00977-1-4700040, +977-9851049206

Fax:- 00977-1-4700040

Merchant Address :- Thamel, Kathmandu , Nepal

Card Holder Details:

Cardholder Name .................................................
Card Number .....................................................
Expiry Date ........................................................
CVV Number ......................................................
(3 digit printed number in the signature panel of card)

Transaction Amount ...........................(USD/INR./NRS.)
Passport Number ..................................................
Billing Address.....................................................
Contact Address .................................................
Phone No :.....................................................
Fax No :....................................................
Email ID :............................................

Disclaimer:

I kindly request you to process above-mentioned transaction. I hereby agree and accept that I have fully read and agreed the terms and conditions for the purchase of goods/ services through this transaction and I hereby indemnify merchant and Himalayan Bank Limited for any disputes arising by virtue of this transaction. The card has been issued in my name and I am the authorized user.

Note: Copy of Passport, Copy of front and backside of card should be enclosed here with.

Sincerely,


............................
Signature

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