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Get Days Inn Credit Card Authorization Form

CREDIT CARD AUTHORIZATION FORM I authorize the DAYS INN of OGDEN to charge my credit card account number given below for the amount of Room rate of TAX per night for Mr/Mrs to arrive on and stay for nights at your establishment. The confirmation number for this reservation is. I also AGREE / DO NOT AGREE CIRCLE ONE to additionally pay for any phone charges incidentals or any other charges incurred by the above named hotel guest during his / her stay at your hotel. Type of credit card VISA MASTER CARD AMEX DISCOVER CIRCLE ONE Credit Card Number Ex. CREDIT CARD AUTHORIZATION FORM I authorize the DAYS INN of OGDEN to charge my credit card account number given below for the amount of Room rate of TAX per night for Mr/Mrs to arrive on and stay for nights at your establishment. The confirmation number for this reservation is. I also AGREE / DO NOT AGREE CIRCLE ONE to additionally pay for any phone charges incidentals or any other charges incurred by the above named hotel guest during his / her stay at your hotel* Type of credit card VISA MASTER CARD AMEX DISCOVER CIRCLE ONE Credit Card Number Ex. / Cardholder s Name CVV Credit Card Billing Address Cardholder s Phone Number Cardholder s Driver License Number I attest the above information to be true and binding Cardholder s Signature Date NOTE Please fax us a copy of your DRIVERS LICENCE and the FRONT and BACK side of the CREDIT CARD listed above along with this form completely filled out. The confirmation number for this reservation is. I also AGREE / DO NOT AGREE CIRCLE ONE to additionally pay for any phone charges incidentals or any other charges incurred by the above named hotel guest during his / her stay at your hotel* Type of credit card VISA MASTER CARD AMEX DISCOVER CIRCLE ONE Credit Card Number Ex. / Cardholder s Name CVV Credit Card Billing Address Cardholder s Phone Number Cardholder s Driver License Number I attest the above information to be true and binding Cardholder s Signature Date NOTE Please fax us a copy of your DRIVERS LICENCE and the FRONT and BACK side of the CREDIT CARD listed above along with this form completely filled out. .

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