Reservations Authorisation < APX Hotels Apartments

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Credit Card Authorisation Form

Reservation # *

Arrival Date *

DD-MM-YYYY

Guest Name *

Departure Date *

DD-MM-YYYY

I / We

(Name in full OR Company Name, if applicable)(Name in full OR Company Name, if applicable)

(ABN#)(ABN#)

hereby authorize APX Hotels Apartments to charge the checked items to the nominated card below for the guest(s) stated above.

Please tick items below. *

All chargesAccommodation Charges OnlyBreakfast ChargesParking ChargesSecurity BondMeal ChargesMinibarPhone Charges

Nominated Credit Card Details:

Credit Card Type *MastercardVisaDiners ClubAmerican Express(Visa and MasterCard attract a surcharge of 1.5%, AMEX and Diners Club attract a surcharge of 3%)

Credit Card Number *0 / 16

CVC *0 / 3

Name (as it appears on the card) *

Expiry Date *MM/YYYY

Consent *

I, hereby authorize APX Hotels Apartments to charge the credit card listed above towards payment for the above reservation charges. If the guest listed above is paying his own account, I authorize APX Hotels Apartments to debit the credit card if the guest defaults or does not make full payment for charges to his account.

Consent Date *

Signature

Start signing your signature here

Please attach a copy of the front and back of driver's license and credit card of the person executing this form when making this reservation. Please note that this authority is not valid until you provide copy of the Driver's License and credit card.

Upload files *

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File types accepted: .jpg, .jpeg, .gif, .png, .pdf / Maximum file size: 8 MB

Please do not fill in this field.