Jgtc

PT Garuda Indonesia (persero) Tbk Letter of Indemnity (LOI) FOR Domestic INTERNET BOOKINGS (Passenger must present the SIGNED LOI, and PHOTOCOPY OF CARDHOLDER Pass Port /driver license (preferred) / ID)

BOOKING CODE (GA): Passenger 1 Name Passenger 2 Name Passenger 3 Name Passenger 4 Name Passenger 5 Name Passenger 6 Name Passenger 7Name Passenger 8 Name Passenger 9 Name First Departure Flight/Date Route Credit Card Number

First 1 digit and last 4 digit (only)

GA

/ Date

X

X

X

X

X

X

X

X

X

X

X

Cardholder Name Cardholder Telephone

I hereby confirm that the above details are correct and that I have purchased the tickets for the passengers specified. (Name as appear on credit card must match name on passport / Driver License /ID of Credit Cardholder)

Terms and Conditions for 3rd Party booking 1. Cardholder authorizing the use of the credit card for the purchase of Garuda tickets must:  Complete & sign the Letter of Indemnity  Produce a clear photocopy of his/her Passport or Driver license(Preferred) or ID  Fax or scan all the above information to Garuda Verification Centre. Fax no: 021-5794 9466 or email to verificationcenter@garuda-indonesia.com After the documents have been verified and approved, Garuda Indonesia shall continue with the check in process Garuda Indonesia reserves the right to refuse carriage to the travelling passengers in case of non-compliance to the 3rd Party booking terms and conditions.

2. 3.

Cardholder Signature

Date

______________________________________

(NAME AS APPEAR ON CREDIT CARD)

_____________________________________

For Official Use only Remarks:

Garuda Indonesia Validation Stamp and Staff Signature

March 2011 Edition