CREDIT CARD AUTHORIZATION FORM

Individual/Business/Group or Event Name:

Reservation Confirmation Number:

Arrival or Event Date(s):

Room & All Applicable Taxes

Food & Beverage

All Incidentals

Only Specific Incidentals All Banquet Charges

Gift Certificate

Guest Amenity

Credit Card Billing Address:

City / State / Zip / Country / Region:

Please fax this completed form to:

Comments:

Credit Card Number:

Expiration Date: Cardholder Phone #:

Signature of Card Holder:

Hotel:

Hotel Fax #:

For a list of all hotels and their contact information, please visit: https://www.hyatt.com/explore-hotels

Current Date:

Resort Services Fee Parking

Contact Phone Number:

I hereby authorize the following amount be applied to the

credit card (applicable sales tax and service charges may apply):

All information is kept confidential and used only for the purposes as noted above.

Other - see comments

Name on Card:

* The credit card listed below may be billed for the estimated charges Ten (10) days prior to event/reservation date.

* Room and tax on individual bookings will be charged 72 hours in advance.

* Hotel reserves the right to refuse a credit card authorization as a valid method of payment for same day bookings or authorization

forms received on day of arrival.

All Stay Charges

Contact Email Address:

By submitting this form and any supporting documents, I confirm that I have read and agreed to the use of the personal information I am

giving you in accordance with your Global Privacy Policy for Guests, which is available at privacy.hyatt.com

*In Australia: An additional service fee will apply to the total stay account when paying by Credit Card upon Departure. Refer to the

hotel's website for more details

* A valid telephone number and email are required as we will need to contact you to confirm receipt. If we are unable to do so, your

reservation will be subject to cancellation.

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

Download the form to your device. Select the hotel from the drop-down to auto-fill the hotel name and associated fax number.

6/23/23