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C .p 200 Platte Oasis Pkwy••North Platte,NE 69101 -7L}} y/ (UPS[A� <br /> Phone(308)534-6000 • Fax(308)534-3415 !' 7�� 1 ` 95 <br /> Official Sponsor <br /> If the debiticredit card you are using for check-in <br /> MUSSETTER, ROBERT name is attached to a bank or checking account,a hold <br /> room number: 32/2014 will lacedon the account for the full anticipated <br /> 7210 LARAMIE RIVER DRIVE address arrival date: 8/5/2014 8:35:00PM p <br /> departure date: 8/6/2014 dollar amount to be owed to the hotel,including <br /> FORT COLLINS,CO 80525 estimated inddentals,through your date of chedc-out <br /> US adult/child: 1/0 and such funds will not be released for 72 business <br /> room rate: $159.00 hours from the date of check-out or longer at the <br /> discretion of your financial institution. <br /> RATE PLAN LVO <br /> HH# 895021111 GOLD <br /> AL UA #00107519068 <br /> BONUS AL CAR <br /> Rates subject to applicable sales,occupancy,or other taxes.Please do not leave any money or items of value unattended in <br /> Confirmation: 82119246 your room.A safety deposit box is available for you in the lobby.I agree that my liability for this bill is not waived and agree <br /> to be held personally liable in the event that the indicated person,company or association fails to pay for any part or the full <br /> amount of these charges.In the event of an emergency,I,or someone in my party,require special evacuation due to a <br /> 8/6/2014 PAGE 1 physical disability.Please indicate yes by checking here:❑ <br /> signature: <br /> date reference description amount tii <br /> 8/5/2014 1483344 GUEST ROOM $159.00 <br /> 8/5/2014 1483344 ROOM TAXES $22.64 <br /> WILL BE SETTLED TO VS*0851 $181.64 <br /> EFFECTIVE BALANCE OF $0.00 <br /> Xt C 159•°10 <br /> xoci?ri <br /> ESTIMATED CURRENCY TOTAL <br /> You have earned approximately 3577 Hilton HHonors points and approximately 159 Miles with United Airlines for this stay. Hilton HHonors(R) <br /> stays are posted within 72 hou s of checkout. To check your earnings or book your next stay at more than 3,900 hotel <br /> Hampton hotels are all over the world. Find us in Canada, Costa Rica,Ecuador, Germany, India, Mexico, Poland, Turkey, United Kingdom, <br /> and United States of America. Coming soon in Italy and Romania. <br /> for reservations caI11.800.hampton or visit us online at hampton.com thanks. <br /> account no. date of charge folio/check no. <br /> 444571 A <br /> card member name authorization initial <br /> establishment no.and location establishment agrees to transmit to card holder for payment purchases&services <br /> taxes <br /> tips&misc. <br /> signature of card member <br /> x total amount <br /> 0.00 <br /> , �r <br /> ::•slnoR; CONRAD Hilton luil„n 't' . suI OD (�rJ U <br /> � a(,tF�u,l, �r�„rtt, HILTON <br /> u:n:m.rna:., suirrs HOME© ;u°„ n HHONORS <br /> .. r - - r;run(t l anon+ <br />