Credit Card Authorization Request

I 	, (as shown on the card) authorize the Holiday Inn

Express & Suites to use my credit card: Number
3 or 4-digit card identification number: Billing address of the credit card:

Expiration date

Phone Number

To pay the charges of: Name of guest Confirmation number Arrival date

Departure date or number of nights

I authorize the following charges: Room and tax only
Room, tax and telephone only
All charges including incidentals

Authorized Signature 	Date

If you need a copy of the bill to be faxed to you upon departure, please enter the number below:

Fax:  	

Attention:  	

Your credit card or debit card will be charged in full for room and tax
(full length of stay) plus an additional 15% incidental deposit will be authorized. Your debit card authorization can take up to 14 days to be released.

This credit card will be used for the charges above if an authorization from the bank is approved. One night of room and tax will be charged in the event of a no-show. Reservation must be canceled by 6pm MT. day of arrival and a cancellation
number must be obtained.

NOT VALID UNLESS ACCOMPAINIED BY A LEGIBLE COPY OF THE FRONT OF THE CREDIT CARD, DRIVERS LICENSE AND SIGNED BY THE CARDHOLDER.