Card Payment Authorization Form - Holiday Inn, St. Louis, Mo

Download a blank fillable Card Payment Authorization Form - Holiday Inn, St. Louis, Mo in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Card Payment Authorization Form - Holiday Inn, St. Louis, Mo with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

811 N. Ninth Street
St. Louis, MO 63101
314-421-4000
Card Payment Authorization Form
Sign and complete this form to authorize Holiday Inn St. Louis to make a debit to your credit or
debit card listed below.
By signing this form you give us permission to debit your account for the amount indicated on or after
the indicated date.
This is permission for a checked transaction only, and does not provide
authorization for any additional unrelated debits or credits to your account.
Please complete the information below:
I
authorize the Holiday Inn St. Louis to charge my credit card
(full name)
Account indicated below for $
on or after
. This payment is for
(amount)
(date)
Group or Guest
Name__________________________________________
________________________________
For the following:
Rooms & Tax
Meeting Rooms & Tax
Parking
Restaurant Charges
Food & Beverage Banquet
Deposits
Bar Charges
AV Charges
Other
If other please describe
Billing Address
Phone#
City, State, Zip
Email
Account Type:
Visa
MasterCard
AMEX
Discover
Cardholder Name
You may enter the
last four digits and have
Account Number
us call you, all other fields
should be completed.
Expiration Date
Please call
CVV2 (3 digit number on back of Visa/MC, 4 digits on front of AMEX)
(emailing credit cards numbers is not always secure!)
Please fax this to 314-421-5974 or email to
SIGNATURE
DATE
I authorize the above named business to charge the credit card indicated in this authorization form according to the terms ou tlined
above. This payment authorization is for the goods/services described above, for the amount indicated above only, and is valid for
checked items only. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card
company; so long as the transaction corresponds to the terms indicated in this form.

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Business
Go