EFTA00314153.pdf
Extracted Text (OCR)
Gift Certificate Authorization Form
SPA
THE PENINSULA
This form has been created in order to allow you to have third party expenses
charged to your credit card. Please provide all the information requested below
to ensure prompt processing. We ask that you either fax this completed form to
The Peninsula Spa at (212) 903-3958 ore-mail it to
GO Card Purchases
Recipient (iii it 1rd/um:rear on the Gift Certifioate):
MC t•-• A Psi I e:
SP I P-16 I-- .1•-• PI%
Please Choose ONE of the following options:
Services to be Received:
Options for Services ONLY:
0 Include Tax on NYC Service Tax)
❑Include Gratuity
Please Note: Prices on all Ceremonies. Retreat Packages and Private Spa Suite Services include an 189E gratuity.
OR
Flat Monetary Amount:
Additional Information
Special Instructions:
Total Value of Gift Card:
43 a 000, 0 0
Delivery Method
Please note that we do not ship gift certificates via US Mail.
rafidc — Up at Spa Reception No Charge
FedEx
K
Fed Ex Next Day: $35.00
0 Fed Ex Second Day: $14.00
0
Own Fed Ex Account Number.
•
Messenger Manhattan Only Not available on weekends
$15.00 Messenger 9AM — 5PM Weekdays ONLY
•
$30.00 Messenger After 5PM Wekkdays ONLY
Ship to:
0 Recipient
0
Purchaser
0 Third Party
Name:
Address:
City, State and Zip:
Cardholder Information
Name as it appears on the credit card:
Type of Card:
Account Type:
0
Visa
0
Mastercard
a
-American Express
Corporate
Company Name:
0
Discover
Account Number.
Exp. Date:
Address (Billing Address):
FR St
- I Sr
.S ".
City. State and Zip:
NI tae GO yr:Iv:2K-
NY
/00
I
Phone Number
a ra -
SD —01 reir
Fax or Alternate Number
I certify that all information is complete and accurate. I hereby authorize The Peninsula Spa, New York to collect payment for all
charges as indicated on this form by processing a charge to the credit card listed above. I certify that I am the authorized signer of the
credit card listed above.
• e that we requir a handwritten signature in order to process this order.
Cardholder Name (Pie• print):
e7s.--6-
Cardholder Signature:
Date:
pc_caS_
EFTA00314153
Document Preview
Extracted Information
Phone Numbers
Document Details
| Filename | EFTA00314153.pdf |
| File Size | 542.8 KB |
| OCR Confidence | 85.0% |
| Has Readable Text | Yes |
| Text Length | 2,151 characters |
| Indexed | 2026-02-11T13:27:14.555694 |
Related Documents
Documents connected by shared names, same document type, or nearby in the archive.