Marriott Credit Card Authorization Form – Fill Out and Use This PDF

Third Party Credit Card Authorization Form

This form has been created in order to allow you to have third party expenses charged to your credit/debit card. I understand that the hotel is not required to accept this form and the guest should check with the hotel to ensure they accept third part transactions (+39 0647091). Please provide all the information requested below to ensure prompt processing of your application. We ask you to please sign and date the form before submission. Please fax the completed form to the attention of ____________________________, The St. Regis Rome at +39 0642014201

FOR SECURITY reasons, Marriott International conforms to all Payment Card Industry (PCI) standards.

CARDHOLDER INFORMATION - Required

Name as it appears on the credit/debit card:

I understand that should there be any issues with the 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.

*(Rate and tax amount must be provided by a hotel representative in order to complete this form.)

I certify that all information is complete and accurate. I hereby authorize The St. Regis Rome (Regis Hotels Management Italy srl) to collect payment for all charges as indicated in the Rate Information and Approved Charges section 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

guest wishes to extend his/her stay. I certify that I am the authorized signer of the credit/debit card listed above. Cardholder Name: (Printed)

Please do not send a photocopy of the front or back of your credit card.

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