Rooming Registration Form Pinehurst Page 2
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1
2Room Rates
Resort Accommodations:
4-Bedroom Villa:
Single Occupancy: $276 per person per night
Single Occupancy: $356 per person per night
Double Occupancy: $193 per person per night
Double Occupancy: $233 per person per night
Rates are per bedroom per night
Registrant’s Name
Guest’s/Children’s Name
Carolina Hotel
Other
Arrival
Departure
(Print legibly)
(Villas, Holly Inn, The Manor)
Date
Date
*Note: Rooms in The Carolina Hotel are sold on a first-come, first-served basis and sell out quickly.
**Print additional copies of this form if needed.
Special Requests_____________________________________________________________________________________________
___________________________________________________________________________________________________________
Tax Exemption
FOR FEDERAL CREDIT UNIONS ONLY
This is an affidavit from ______________________________ FCU to meet the requirements of the state of North
Carolina Department of Revenue Sales and Use Tax Regulation 48. Section b. Our Federal Tax number is ____________.
This is an affidavit from ______________________________ FCU to meet the requirements of the state of South
Carolina Department of Revenue Code section 12-26-2120(2). Our Federal Tax number is ________________________.
We are charter number ____________________________ under the laws of the National Credit Union Administration, an
agency of the U.S. government. As such, Federal Credit Unions are exempt from sales and use tax in accordance with
Section 1768 or Title 12 of the US Code.
We are not subject to North Carolina sales tax as set forth in the State of North Carolina Department of Revenue, Sales
and Use Tax regulation 48. Federal Credit Unions’ exemption from sales and use tax is also in accordance with Statue
405 of Statutory Authority G.S. 105-164.13.
Pinehurst Payment Options
MASTER BILLING: GROUP
Credit Card
Credit Card Type _________________
Card Number ________________________________________
Expiration Date _________________
Authorized Signature __________________________________
Please check applicable charges for Master Billing.
Guest Rooms & Tax
Recreation Charges
All Food/Beverage Charges
Merchandise/Purchases
ALL Charges (to include incidentals)
PAY BY CREDIT CARD OR CHECK: INDIVIDUAL
Credit Card
Credit Card Type _________________
Card Number ________________________________________
Expiration Date _________________
Authorized Signature __________________________________
Check Attached
Check # __________________________________________
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