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We ask that you please sign and date the form before submission.  \nCARDHOLDER INFORMATION-Required  \nGUEST INFORMATION-Required  \nGuest Name (s) : ___________________________________________________________________________________________Company:    \nPhone Number:   Fax or Alternate Number:    \nConfirmation Number:   Arrival Date:   Departure Date:    \nRelation to Cardholder: Relative Friend Business Associate Other  \nI understand that should there be any issues with this credit/debit card being used to settle my charges, I will be responsible for all expenses incurred during my stay. Departure date cannot be extended unless a new authorization form is completed.  \nRATE INFORMATION AND APPROVED CHARGES-Required  \nRoom rate:*   Taxes:*   Total Daily Rate:*   Number of nights:    \n* (Rate and tax information must be provided by a hotel representative)  \n\n| All Charges | Room and Tax | Telephone (LD) | Restaurant | Room Service |\n| --- | --- | --- | --- | --- |\n| Valet (Laundry) | Parking | Internet Access | Movies | Other |\n\nI certify that all information is complete and accurate. I hereby authorize   to collect payment for all charges as indicated in the “Rate Information” and “Approved Charges” sections of this form, by processing a charge to the credit/debit card listed above. Charges must not exceed   for the entire stay/event. I understand that a new form will have to be completed if the guest wishes to extend his/her stay. I certify that I am the authorized signer of the credit/debit card listed above.  \nCardholder name (printed):   Cardholder signature: Date:","cbCaivsffjEbwZJV","https://ap.wps.com/l/cbCaivsffjEbwZJV","pdf",1759981,"English","# Cardholder Information\n## Guest Information\n# Rate Information and Approved Charges\n## Certification and Authorization","[{\"question\":\"What information is required from the cardholder and the guest?\",\"answer\":\"The form collects cardholder details and guest information, including guest name(s), company, phone and alternate contact, confirmation number, arrival and departure dates, and the guest’s relation to the cardholder.\"},{\"question\":\"What charges can be included in the approved charges section?\",\"answer\":\"Approved charges cover room and tax plus additional categories such as telephone (LD), restaurant, room service, valet (laundry), parking, internet access, movies, and other items.\"},{\"question\":\"What happens if the guest needs to extend the stay?\",\"answer\":\"Departure date cannot be extended unless a new authorization form is completed, and a new form must be submitted for any extension.\"}]","Credit Card Authorization Form - Payment Authorization for Third-Party Charges - for Hotel Stays | PDF",1789623401]