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Credit Card Authorization Letter
Credit Card Authorization Letter
I, (print name as appears on card) authorize the use of my
credit card described below for charges related to services provided by the Mosley Motel.
Credit Card Type : Visa MasterCard
Credit Card Number:
Expiration Date:
Name of Card Holder:
Signature:
Date:
**NOTE: Must include a copy of front and back of the credit card. The back of the card must
be signed. **
I understand that the amount charged to my credit card will be reflected on my credit card
statement within seven days of authorization. The amount charged is based on services
requested by me.
Signature:
Date:
Billing Zip Code:
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