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Credit Card Authorization Form For Deposit and/or Payment of Vacation Rentals

We process and charge your card in house "by hand" using the information provided in this form

Visa or
Mastercard
Only

 

 

 Rentor/Cardholder Billing Information

Cardholder's Name:(First, Last)

Billing Address:

City:
 State:
 Zip:

Email Address:

Daytime Phone:

 		 Fax:

 
Credit Card Type:
 :

 
Credit Card Number:
 Expiration:Date

Card Verification Code
This is the 3 or 4-digit number located on the front or back of card,
:

Total

Daily Rental Amount $

Weekly Rental Amount $

*Lodging Tax & cleaning fee will be added into final amount

 
   
   

* Please note that the Cardholder Name and Address that you list on this form must match the information on the credit card for the authorization to be accepted by Visa or MasterCard

 

 

 

 

  









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