EFTA00129470





# Hilton Suites



DELRAY BEACH, FL 33444

US

<table><thead><tr><th>Room</th><th>120/K1RVQ1</th></tr></thead><tbody><tr><td>Arrival Date</td><td>11/3/2009</td></tr><tr><td>Departure Date</td><td>11/3/2009</td></tr></tbody></table>

<table><thead><tr><th>Adult/Child</th><td>1/0</td></tr></thead><tbody><tr><td>Room Rate</td><td>79.50</td></tr></tbody></table>

| RATE PLAN | D-DU |

| :--- | :--- |



HH#

AL:

BONUS AL: CAR:



CONFIRMATION NUMBER: 3367746107





11/3/2009 PAGE 1



8:04:00AM

Folio

<table><thead><tr><th>DATE</th><th>DESCRIPTION</th><th>ID</th><th>REF. NO.</th><th>CHARGES</th><th>CREDITS</th><th colspan="2">BALANCE</th></tr></thead><tbody><tr><td>11/3/2009</td><td>GUEST ROOM</td><td>ELKIWI</td><td>845524</td><td>$79.50</td><td rowspan="4"></td><td rowspan="4" colspan="2">$88.65</td></tr><tr><td>11/3/2009</td><td>RM STATE TAX</td><td>ELKIWI</td><td>845524</td><td>$5.17</td></tr><tr><td>11/3/2009</td><td>RM OCCUPANCY TAX BALANCE</td><td>ELKIWI</td><td>845524</td><td>$3.98</td></tr><tr><td></td><td></td><td></td><td></td><td></td></tr><tr><td colspan="5">ACCOUNT NO.</td><td>DATE OF CHARGE</td><td colspan="2">POLIO NO./CHECK NO. 169693 A</td></tr><tr><td colspan="5">CARD MEMBER NAME</td><td colspan="2">AUTHORIZATION</td><td>INITIAL</td></tr><tr><td colspan="5">ESTABLISHMENT NO. &amp; LOCATION ESTABLISHMENT AGREES TO TRANSMIT TO CARD HOLDER FOR FAYENCE</td><td colspan="3">PURCHASES &amp; SERVICES</td></tr><tr><td colspan="5">THANK YOU FOR STAYING AT THE HILTON SUITES BOCA RATON</td><td colspan="3">TAXES</td></tr><tr><td colspan="5"></td><td colspan="3">TIPS &amp; MISC.</td></tr><tr><td colspan="5"></td><td>TOTAL AMOUNT</td><td colspan="2"></td></tr></tbody></table>

MERCHANDISE AND IOR SERVICES PURCHASED ON THIS CARD SHALL, NOT BE RESOLD OR RETURNED FOR A CASH REFUND.



PAYMENT DUE UPON RECEIPT
















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