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<br />******************************************************************...***....********************* <br /> <br />I, <br />to charge my: <br /> <br />, authorize Microtellnn & Suites - Zephyrhills, FL <br /> <br />American Express <br />Mastercard <br />Other <br /> <br />Card Number~ 0 ill 0()02 t5fttxpiration Datecel (I <br /> <br />V Visa <br />Discover <br /> <br />To pay for the reservation above. * <br />This card will cover <br /> <br />~ Room and Tax only 4-lrolda-t\~ +-\A1G <br />Room, Tax and Intemationall Operator Assist Phone Calls <br />__ Room, Tax and all Incidentals <br /> <br />. NOTE: THE CREDIT CARD LlSTEO Will BE CHARGED FOR THE FULL <br />AMOUNT OF THE AUTHORIZED CHARGES AT CHECKIN OF THE GUEST. <br />ANY ADDIT10NAl ROOM NIGHT or INCIDENTAL CHARGES MUST BE <br />AUTHORI,ZED BY THE COMPLETION OF AN ADDITIONAL CREDIT CARD <br />AUTHORIZATION.. . <br /> <br />* In order for us to use the informali ~~ou must return the form to <br />us before check-in. It can be faxed to - N: Front Desk. The form <br />must be filled out in its entirety, and contain an authorized signature. WE ALSO NEED <br />A, PHOTOCOPY OF THE CREDIT CARD - FRONT AND BACK - SHOWING THE <br />AUTHORIZED SIGNATURE, CARD NUMBER, AND EXPIRATION DATE. (The best <br />way to copy the card is to set your copier to the lightest setting.) <br /> <br /> <br /> <br />Please print the name that appe <br />Authorized Signaturel - <br /> <br />