Holiday Inn Receipt

Date Format

Font Style

Print Date

Arrive date

Depart Date

Guest Name

Country

City, State, Zip

Folio No.

A/R Number

Group Code

Company

Membership No.

Invoice No.

Room No.

Conf. No.

Rate Code

Page No.

Guest Signature

Hotel Address

Hotel Fax

Contact Number

Payment Type

Card No

Guest Signature Content

Without Watermark

I agree to the Terms of Service and confirm legitimate use only.

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10-16-2026

John Smith

United States

Folio No.

817737

A/R Number

AR-202610-462531

Group Code

GROUP26-8832

Company

Local

Membership No.

128271845

Invoice No.

INV-202610-222480

Room No.

101

Arrival

10-16-2026

Departure

10-16-2026

Conf. No.

706674644

Rate Code

EJPH

Page No.

1 of 1

Date	Description	Charges	Credit

Total0.000.00

Balance

0.00

Guest Signature:

I have received the goods and/or services in the amount shown hereon.I agree that my liability for this bill is not waived and agree to be held personally liable in the event that the indicated person, company, or associate fails to pay for any part or the full amount of these charges. If a credit card charge, I further agree to perform the obligations set forth in the cardholder’s agreement with the issuer.

Holiday Inn Express Lodi 1337 East Kettleman Lane Lodi, CA 95240

Telephone: (209)220-0125 Fax: (206)325-5258