Hyatt Credit Card Authorization Form
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HYATT HOTELS CREDIT CARD AUTHORIZATION FORM
Hotel:

Individual/Business/Group or Event Name:
Reservation Confirmation Number:
Arrival or Event Date(s):
Credit Card Billing Address:
City / State / Zip / Country:
Contact Phone Number:

Contact Email Address:

I hereby authorize the following charges to be applied to the following credit card.
Check all that apply:
Room & Tax

Only Specific Incidentals

Gift Certificate

All Stay Charges

Food & Beverage

All Banquet Charges

Guest Amenity

Other - see comments

All Incidentals

Resort Services Fee

Parking

I hereby authorize the following amount be applied to the
credit card (applicable sales tax and service charges may apply):
Comments:
The credit card listed below may be billed for the estimated charges Ten (10) days prior to event/reservation date.

Credit Card Number:

Name on Card:

Expiration Date:

Cardholder Phone #:

Current Date

Signature of Card Holder:

By submitting this form and any supporting documents, I confirm that I