HIE Credit Card Authorization Form - Holiday Inn Express ...

12683 West Indore Place Littleton, Colorado 80127 Phone: 720.981.1000 :: Fax: 720.981.1507

Credit Card Authorization Request

I _________________________, (as shown on the card) authorize the Holiday Inn Express & Suites to use my credit card:

Number ______________________________ Expiration date __________ 3 or 4-digit card identification number: _________ Billing address of the credit card: _________________________________ ____________________________________________________________ ____________________________________________________________ Phone Number ________________________________________________

To pay the charges of: Name of guest ______________________________________________________ Confirmation number__________________________ Arrival date ____________ Departure date or number of nights _____________

I authorize the following charges: ______ Room and tax only ______ Room, tax and telephone only ______ All charges including incidentals

___________________________ Authorized Signature

__________ Date

If you need a copy of the bill to be faxed to you upon departure, please enter the number below:

Fax: ________________________ Attention: _________________________

Your credit card or debit card will be charged in full for room and tax (full length of stay) plus an additional 15% incidental deposit will be authorized. Your debit card authorization can take up to 14 days to be released.

This credit card will be used for the charges above if an authorization from the bank is approved. One night of room and tax will be charged in the event of a no-show. Reservation must be canceled by 6pm MT. day of arrival and a cancellation number must be obtained.

NOT VALID UNLESS ACCOMPAINIED BY A LEGIBLE COPY OF THE FRONT OF THE CREDIT CARD, DRIVERS LICENSE AND SIGNED BY THE CARDHOLDER.

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