Seattle Marriott Bellevue Credit Card Authorization
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1Hotel Name:
Seattle Marriott Bellevue
Address:
Credit Card Authorization
City, State, Zip:
Fax Number:
PLEASE PRINT
Group Name:
Date(s) of Event:
Contact Name:
Contact Phone #:
Contact Title:
Contact Email:
Estimate of Guaranteed Charges
Authorized to Sign for Charges
Guest Rooms
$ ____________
Meeting Rooms
$ ____________
Print Name: ____________________ Signature: ________________________
Guest Incidentals
$ ____________
Other _________
$ ____________
Print Name: ____________________ Signature: ________________________
Banquet Food
$ ____________
Other _________
$ ____________
Print Name: ____________________ Signature: ________________________
Banquet Bar
$ ____________
TOTAL
$ ____________
Print Name: ____________________ Signature: ________________________
I hereby authorize Marriott Bellevue to charge by personal/corporate credit card for expenses incurred as noted above.
Signature of Cardholder _____________________________________________________ Date _______________
Cardholder Name _____________________________________________________
Credit Card Number ___________________________________________________
Credit Card Type _____________________________________________________
Expiration Date _____________________ Security Code ____________________
Credit Card Billing Address _____________________________________________
_____________________________________________
If you would like to have a copy of the final paid bill sent to you, please fill out the following:
Company Name ________________________________________________________________________________
Contact Name __________________________________________________________________________________
Address _______________________________________________________________________________________
City ____________________________________________________ State __________ Zip _________________
Phone Number _________________________________ Fax Number ____________________________________
Email _________________________________________________________________________________________
PCI COMPLIANCE MANDATES THAT FORM MUST BE FAXED TO 425-557-3606 DO NOT EMAIL
Form must be received by the Hotel at least three (3) days prior to check-in or function date.
Hotel Use Only
Posted Date
Approval Code
Amount
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Parent category: Business