ONLINE PAYMENT


Customer Information
First Name :
Last Name :
Occupation :
Gender :
Cell Phone :
E-mail :
Address :
Purchased Service/Product :
Credit Card Information
Card Holder Name:
Card Number:

Security Code/CVV:
Card Expiration Date:

Card Type:
Passport / ID Number:

Payment Information
    Amount In US$ (50%):
    Amount In US$ (100%):

Service Charge (3%):
Net Total In US$:
Purposes:

AUTHORIZATION LETTER

I/ We,  holding the below card number hereby authorize the merchant Lyna-CarRental.Com located at No.132, Street 460, Tumnop Teuk, Chamcarmon, Phnom Penh, Cambodia to withdraw the purchase amount from the card.

Cardholder Name: Passport /ID No:
Name on Card: Card Expiry Date:
Purchased Service / Product: Card Type:
Authorized Amount :
Authorized Amount in Word:
Address:


_______________________________
Cardholder Signature:
............/............/...........
Date:

Merchant Declaration:

We,Lyna-CarRental.Com assure that all the above cardholder information is used to make the transaction authorized by the cardholder and will not disclose to other persons other than ABA Bank.
 Please Print it out and sign, then send the signed copy to us in the next step. Thank you for your relying on and supporting to our service. Kind regards..!  

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TESTIMONIALS

Date : 29-Sep-2017| Subject :We were happy with y

Dear Mrs Tan, We already rent a car w...

Date : 01-Jan-1970| Subject :rent a car with a dr

We are 4 persons and we want to rent a c...

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