Guest House Direct Bill Request and Authorization Form
Guest Name(s):
Your answer
Arrival Date *
MM
/
DD
/
YYYY
Departure Date *
MM
/
DD
/
YYYY
Room Type
Guest's Citizenship and Country of Birth
Your answer
Guest's Phone Number:
Your answer
Guest's Address
Your answer
Guest's Email Address:
Your answer
LBL Requester Information
Project ID *
***Project ID and Activity Code MUST be provided for processing***
Your answer
Activity Code: *
Your answer
Authorized Booker:
Your answer
Division Business Manager
Your answer
Department
Other Department
Your answer
Requester Phone:
Your answer
Requester Email:
Your answer
I authorize the Berkeley Lab Guest House to bill my department or organization for the lodging expenses for this guest. The LBL Travel Office will not allow billing for any expense other than lodging on this invoice. *
Department may be billed one night for "No-Show" reservations that are not cancelled 24 hours prior.
Required
Special Requests/Notes:
Your answer
Berkeley Lab Guest House
1 Cyclotron Road, MS 23-R0100, Berkeley CA 94720
Federal Tax ID #: 94-2814979
Phone: (510) 495-8000 • Fax: (510) 495-8800
email: reservation@berkeleylabguesthouse.org
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