Hotel / Third-Party Credit Card Authorization Form Template

Hotel Name: [Hotel Name]
Hotel Address: [Address]
Phone: [Phone]
Email/Fax (Optional): [Email/Fax]
Reservation Number (Optional): [Reservation #]

Date: [Date]

1. Guest / Reservation Details

1.1 Guest Name: [Guest Full Name]
1.2 Check-In Date: [Date]
1.3 Check-Out Date: [Date]
1.4 Room Type / Number (Optional): [Details]
1.5 Number of Guests (Optional): [Number]

2. Cardholder Information (Person Paying)

2.1 Cardholder Name: [Full Name]
2.2 Billing Address: [Address]
2.3 Phone: [Phone]
2.4 Email: [Email]
2.5 Relationship to Guest (Optional): ☐ Employer ☐ Family ☐ Friend ☐ Other: [Explain]

3. Credit Card Information (Handle Securely)

3.1 Card Type: ☐ Visa ☐ Mastercard ☐ American Express ☐ Discover ☐ Other: [Type]
3.2 Name on Card: [Name]
3.3 Card Number: [Number]
3.4 Expiration Date: [MM/YY]
3.5 Security Code (CVV) (If Required): [CVV]
3.6 Last 4 Digits (Optional safer option): [####]

4. Charges Authorized

4.1 The cardholder authorizes the hotel to charge the credit card for the following (select all that apply):
☐ Room rate
☐ Taxes and fees
☐ Incidentals (parking, minibar, phone, etc.)
☐ Meals/Restaurant
☐ Meeting/banquet charges
☐ Other: [Describe]

4.2 Spending Limit (Optional):
☐ No limit
☐ Limit total charges to $[Amount]
☐ Limit incidentals to $[Amount] per day

4.3 Authorized Date Range: From [Start Date] to [End Date].

5. Identification and Supporting Documents (If Required)

5.1 The hotel may require the following:
☐ Copy of card (front only)
☐ Copy of cardholder photo ID
☐ Signed registration card at check-in
☐ Other: [List]

6. Authorization and Acknowledgments

6.1 I authorize the hotel to charge the credit card identified above for the charges selected in Section 4 for the guest/reservation listed in Section 1.
6.2 I understand that I am responsible for authorized charges and that the guest may be required to provide a separate card for incidentals if not authorized here.
6.3 I understand this authorization does not guarantee availability, rates, or hotel policies and is subject to the hotel’s terms.

Signatures

Cardholder Name: [Full Name]
Date: [Date]
Signature: ___________________________

Hotel Representative (Optional): [Name]
Title/Role: [Title]
Date: [Date]
Signature: ___________________________