Harbor Lane Inn
42 Quay Street, Seaview
(555) 014-7731
reservations@harborlane-inn.example
Third-Party Hotel Credit Card Authorization Form
I am the cardholder. I authorize Harbor Lane Inn to charge the card below for the guest's stay shown, for the charges this card covers only, under the terms on this form.
The stay
Charges this card covers
Cardholder
Terms
- Cancellation: Cancel by the date and time shown above and there is no charge.
- No-show: If the reservation is not cancelled in time and the guest does not arrive, we charge one night's room rate plus tax.
Cardholder signature
Date
We will enter these card details with our payment processor, then cross-cut shred this strip.
Card details (filled in by the cardholder)
Do not write the card's security code (the 3- or 4-digit code on the front or back of the card) anywhere on this form.
