Marriot Electronic Credit Card Authorization Form
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1ELECTRONIC CREDIT CARD AUTHORIZATION FORM
Name of Guest
Reservation #
Arrival Date
_____________________________
_____________
_____________
_____________________________
_____________
_____________
_____________________________
_____________
_____________
ESTIMATED CHARGES
Complete Estimated Charges Amounts
HOTEL:
Please Initial all Authorized Charges
CARDHOLDER:
CHARGE
AMOUNT
INITIAL
All Charges
____________
_________
Room, Taxes & Fees
____________
_________
Parking
____________
_________
Amenities
____________
_________
Other _____________________
____________
_________
Other _____________________
____________
_________
Other _____________________
____________
_________
____________
_________
TOTAL ESTIMATED CHARGES
CREDIT CARD INFORMATION
Please Complete this Section
CLIENT:
Name of Person Completing Form
________________________________________________
Phone Number
__________________________
Email Address
________________________________________________
Card Holder Name
________________________________________________
Credit Card Number
________________________________________________
Credit Card Expiration
__________________________
Type of Card
________________________________________________
Card Holder Billing Address
________________________________________________
________________________________________________
Card Holder Drivers License #
________________________________________________
Today’s Date
__________________________
Upon submission of this form, I hereby authorize Warner Center Marriott located at 21850 Oxnard St, Woodland Hills, CA 91367,
to charge my credit card immediately for the above noted charges. I understand that a final billing statement will be provided within five (5) days of the
conclusion of the stay and that any unpaid balance or credit due will be applied to this credit card.
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