Credit Card Authorization
1611 Airport Commerce Dr.
Austin, TX 78741
Credit Card Authorization Form
Guest Name: ___________________________________________________________
Confirmation Number: _____________________ Arrival Date:_________________
Full Name on Credit Card: _______________________________________________
Contact Phone Number: _________________________________________________
Authorized Signature: ___________________________________________________
Type of Credit Card: VISA / Master Card / Discover / JCB / AMEX
Card Number: ______________________________________ Expiration:__________
This card is authorized for: (CHOOSE ONE*)
Guarantee Only: This card is not authorized for charges but will guarantee/hold
reservation. . Card will only be charged in the event that the reservation cancels after
grace period and/or No-Show.
Room & Tax Only: This card is authorized only for standard room & tax charges during
the stay. [Guest must have own Credit Card or Cash Deposit at check-in for any
All Charges: This card is authorized for ALL charges, including any incidental charges
that occur during the stay (damages, phone calls, etc)
Also: Make a legible copy (front and back) of the credit card and a copy of the driver license
or legal picture ID of the authorized signer.
Note: Should any information above be missing, the authorization may be voided. Please
make sure you have circled an option for the authorization charges *, as well as filled out all
other credit card and reservation requirements.
By completing and submitting this form, you authorize the Staybridge Austin Airport , to charge for the
indicated room(s) or function. You further agree that any dispute will be resolved within 10 days of the
arrival/check-in date. You understand that approval authorization may be made with the credit card
company 72 hours prior to afore mentioned date.
Review form and verify that it has been completed thoroughly before submission via Fax