Credit Card Authorization Form AL Serial #

Mahoning Inn www.mahoninginn.com
71 Blakeslee Blved. East, Lehighton, PA 18235
Ph: 610-377-1600 Fax: 610-379-0194

 

Note: Please Print then fill out and fax back within 48 hours.

If you choose credit card authorization as our method of payment

there will be a 3% processing fee. (Example: $50 x 3%=$1.50)

I Mr./Mrs.__________________ Authorize Mahoning Inn

to charge my credit card for ______nights plus tax for a total of $_________.

I allow the following charges to be charged on my credit card.

Phone Charges yes/no DVD Charges yes/no Incidental Charges yes/no

Arrival Date:__________ Departure Date:__________

Card Type:__________ Security Code(3 digit on back of card)______

Card Holder's Name:________________________ Company Name:________________

Card Number:___________________________ Expiration Date:________________

Contact Number:_________________________ Email:________________________

Cancellation Policy:_______________________ Room Rate:$___________________

I UNDERSTAND THAT I AM RESPONSIBLE FOR ALL CHARGES INCURRED ON THIS ACCOUNT.
Card Holder's Name:______________________Signature:________________________

Card Holder's Address:________________________________________

________________________________________

_________________________________________
BECAUSE OF SECURITY REASONS WE ASK YOU TO PLEASE

ATTACH A COPY OF YOUR DRIVERS ID AND CREDIT CARD FRONT AND BACK
*One authorization letter can be used for one stay unless you want to set up "OPEN AL" you can discuss this option with a manager.
We appreciate your business. Thank You
Mahoning Inn

Rm. #_________________________CF#_______________Desk Clerk___________Date_______

 

All Major Credit Cards Accepted including