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    Marriott - CC Auth Form - English

    Uploaded by

    jT
    This payment authorization form allows charges from a hotel stay to be charged to a credit card. It includes guest information for John Berg, Ronald Stringer, and Alina Sixtos staying from May 30 to June 6. The form approves charging the room rate, taxes, and other expenses like telephone calls, restaurant charges, and movies to the credit card provided for Johnathan Berg. The cardholder's signature authorizes the hotel to charge the listed card for all expenses incurred during the stay.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Marriott - CC Auth Form - English

    Uploaded by

    jT
    2K views1 page
    This payment authorization form allows charges from a hotel stay to be charged to a credit card. It includes guest information for John Berg, Ronald Stringer, and Alina Sixtos staying from May 30 to June 6. The form approves charging the room rate, taxes, and other expenses like telephone calls, restaurant charges, and movies to the credit card provided for Johnathan Berg. The cardholder's signature authorizes the hotel to charge the listed card for all expenses incurred during the stay.

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    This payment authorization form allows charges from a hotel stay to be charged to a credit card. It includes guest information for John Berg, Ronald Stringer, and Alina Sixtos staying from May 30 to June 6. The form approves charging the room rate, taxes, and other expenses like telephone calls, restaurant charges, and movies to the credit card provided for Johnathan Berg. The cardholder's signature authorizes the hotel to charge the listed card for all expenses incurred during the stay.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    2K views1 page

    Marriott - CC Auth Form - English

    Uploaded by

    jT
    This payment authorization form allows charges from a hotel stay to be charged to a credit card. It includes guest information for John Berg, Ronald Stringer, and Alina Sixtos staying from May 30 to June 6. The form approves charging the room rate, taxes, and other expenses like telephone calls, restaurant charges, and movies to the credit card provided for Johnathan Berg. The cardholder's signature authorizes the hotel to charge the listed card for all expenses incurred during the stay.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Payment Authorization Request:

    Please complete this payment authorization form to allow the third-party expenses outlined below to be charged to your credit/debit card.
    Click here to open Marriott Privacy Center
    Guest Information

    Confirmation Number: 76136007 Arrival Date: 5/30/2021 Departure Date: 6/5/2021


    Guest Name: John Berg, Ronald Stringer, Alina Sixtos

    Company Name:

    Phone Number: (214)814-2816

    Address: 2931 Shelby Avenue

    City, State, Zip: Dallas, TX 75219-5735

    Relation to Cardholder: ✔ Relative ✔ Friend Business Associate Other:


    (if applicable)

    Rate Information and Approved Charges:


    ■ All Charges Room & Tax Telephone (LD) Telephone (Local) Restaurant
    Room Service Valet/Laundry Parking HS Internet Access Movies
    Event/Catering/Banquet Charges
    Other:

    Currency type: American Express

    Charges must not exceed for the entire stay/event

    Room Rate: Taxes: Total Daily Rate: Number of Nights:


    Comments/Special Requests:

    Payment Information:

    **** **** **** 5008

    JOHNATHAN BERG
    2931 Shelby Avenue
    Dallas, TX 752195735
    United States of America

    APPROVED 5/31/2021 ID: 20210531023027293 Cardholder Phone Number: (214)814-2816

    Acceptance and eSignature:


    ✔ I authorize the hotel mentioned above to charge payment for all charges as indicated in the Rate Information and Approved
    Charges section of this form by processing a charge to the credit/debit card listed above. I confirm that all guests listed above are age 18
    or older. I am the authorized signer for the payment information attached.

    Cardholder Signature:
    Johnathan Ryan Berg Date: 05/31/2021
    [email protected]

    Doc ID: 20210529194233461


    Sertifi Electronic Signature

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