3910 S High St.,
Columbus OH 43207
PH: (614) 409-1373, FAX: (614) 409-1643 Credit
Card Authorization
Date:
Attn: Confirmation # :
1
Bed :+ tax
2Beds:+ tax Rates are with AAA discount |
Smoking/Non-smoking
This is to confirm the authorization to use my credit card for payment
of my reservation of room charges while staying at your Budget Inn
Express. I understand that your cancellation policy is no later
than 24 hrs prior to the reservationdate. I understand
that if I do not cancel my reservation by the specific deadline, I
will be charged the full rate. If I would like to cancel the
reservation, both the nights will be cancelled. If you are making the
reservation for the third party please write their name in the
Authorization for Name and sign. If you or your person does not show
up you will be charged the full rate. Must Fax the copy of the
Drivers License of Credit card holder.
Dates: Arrival Departure .
Card Type:
(You must have to use the same card.)
Name on the credit card :
. Authorization for Name :
. Credit card no:
Expiry Date:
/
.(MM/YYYY)
Home Phone: (
)
. Work Phone: (
)
.
Fax: (
)
. Cardholders Signature: X
. Address:
.
City, State, Zip:
. Please FAX this form in 15 min. of printing. Call us before you
fax so we can be prepared.
For office use only (Time::
)
Name on reservation:
.
Folio/confirmation number:
.
Print
(You must have to use the same card.)