CREDIT CARD AUTHORIZATION FORM
This form must be completely filled out and sent back to
[email protected]
CARDHOLDER INFORMATION:
Name as it appears on Card ________________________________________________________________________
Billing Address of Card Holder _____________________________________________________________________
City, State, Zip Code: ____________________________________________________________________________
RESERVATION INFORMATION:
Name on Reservation ___________________________________________________________________________
CREDIT CARDHOLDERS INFORMATION:
Credit Card Type & Card Number __________________________________________________________________
Expiration Date / CVV Code ________________________
Email Address for Card Holder ___________________________________________
Phone Number for Cardholder ______________________________ Date ____________________
*I certify the information provided on this form is true / correct. I am an authorized signer on the card listed above. I agree in the event of a discrepancy to the account to notify the accounting department within seven working days of receiving the credit card statement.
Print Name of Cardholder as it appears on Card ___________________________________________________________
THE FOLLOWING CHARGES ARE AUTHORIZED TO BE BILLED TO THE ABOVE CREDIT CARD:
Deposit OF $200 (only deposit amount is charged at time form is received)
Remaining Balance of Selected Package (Although only the deposit amount is charged at time form is received, the balance will be charged 2 days prior to arrival.) If you wish to use a different credit card for the final payment, you must call Innisbrook Group Reservations at 833-908-1352.
This form must be completely filled out and sent back to
[email protected]
CARDHOLDER INFORMATION:
Name as it appears on Card ________________________________________________________________________
Billing Address of Card Holder _____________________________________________________________________
City, State, Zip Code: ____________________________________________________________________________
RESERVATION INFORMATION:
Name on Reservation ___________________________________________________________________________
CREDIT CARDHOLDERS INFORMATION:
Credit Card Type & Card Number __________________________________________________________________
Expiration Date / CVV Code ________________________
Email Address for Card Holder ___________________________________________
Phone Number for Cardholder ______________________________ Date ____________________
*I certify the information provided on this form is true / correct. I am an authorized signer on the card listed above. I agree in the event of a discrepancy to the account to notify the accounting department within seven working days of receiving the credit card statement.
Print Name of Cardholder as it appears on Card ___________________________________________________________
THE FOLLOWING CHARGES ARE AUTHORIZED TO BE BILLED TO THE ABOVE CREDIT CARD:
Deposit OF $200 (only deposit amount is charged at time form is received)
Remaining Balance of Selected Package (Although only the deposit amount is charged at time form is received, the balance will be charged 2 days prior to arrival.) If you wish to use a different credit card for the final payment, you must call Innisbrook Group Reservations at 833-908-1352.