Please check and book & confirm:


Credit Card: .............................................................................
( Name der Kreditkarte )

Credit Card Holder: .................................................................
( Name Kreditkartenhalter )

Credit Card No.: ......................................................................
( Kreditkartennummer )

Expiry Date: ..............................................................................
( Gültig bis )

Amount Euro .............................................................................
( Betrag )

Billing Address: ..........................................................................
( Rechnungsadresse )
..................................................................................................

..................................................................................................

Hiermit bevollmächtige ich International Company Formations Ltd. unwiderruflich den o.a. Betrag von der oben angegebenen Kreditkarte abzubuchen. Eine Kopie meines Passes füge ich bei.

I hereby authorise International Company Formations Ltd. the above mentioned sum from the above mentioned Credit Card to debit. A copy of my passport is attached.


Name: .................................. Datum / Date:..............................

Unterschrift / Signature: ............................................................