Credit Card Authorisation Form Reservation # *Arrival Date *DD-MM-YYYYGuest Name *Departure Date *DD-MM-YYYYI / 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 ChargesNominated 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 / 16CVC *0 / 3Name (as it appears on the card) *Expiry Date *MM/YYYYConsent *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 *SignatureStart signing your signature hereYour browser does not support e-Signature field.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 *Drag and Drop (or) Choose FilesFile types accepted: .jpg, .jpeg, .gif, .png, .pdf / Maximum file size: 8 MB SUBMITPlease do not fill in this field.
