Simpático Rental Registration Form:

Andrew A. Stock 
1288 Columbus Ave. #212
San Francisco, CA 94133
USA
Cell:     (415) 999 2639
Fax:     (415) 441 2332
aastock@yahoo.com

www.mexicoretreat.net

Call (415) 999 26 39 for bank transfer information

Please include (for security purposes only)
Visa / Master card number:

 ______________________________

Expires: _______      Billing Address:

 ______________________________

Playa La Manzanilla, Nayarit, Municipal of San Blas, Mexico
Phone/Fax from the USA:                 011  52 (323) 254 9122
From Mexico:                                         01 (323) 254 9122
Adan and Rosa Patron (caretakers)          01 (323) 234 9314

Guest(s) Names & Home and work address:

__________________________    ___________________________________________________

__________________________    ___________________________________________________

__________________________    ___________________________________________________
 
Phone #
.______________   Evening: _________________ email:_________________


Double Occupancy Fees (checks & transfers) - (Additional persons over age 12: $15/day ea.)
 
2 nights:                                 $    170
Per week (7 nights)                  $    480 (pro-rating: 65$ per day)
One month                              $ 1,250

Note: The prices above are high season's, from November thru April. Please deduct 20% for the period
between May thru October.

          Dates of use: From: __________________________ to: _____________________

          Flight arrival information: _______________________________________________

Number of nights:         ____ x  $_____      =            Total rent         $__________


Number of weeks:        ____ x  $_____      =             Total rent         $__________


50% deposit required to hold the dates                                            $__________


25% Security Deposit   (No smoking please)                                     $__________
Cleaning or damage costs will be deducted.

Agreed:

________________________    ____________           ____________________     _________

                 Guest                             Date                     Andrew A. Stock                Date

 

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