It is our pleasure to accept your credit card for... form allows us to follow your authorization details, and is...

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It is our pleasure to accept your credit card for payment on the account of your designation. This
form allows us to follow your authorization details, and is restricted for use only for the person,
charges and dates you specify.
FAX TO
RETURN TO
NAME:
ATTN: Reservations
COMPANY:
PHONE: 503-228-2000
FAX NUMBER:
FAX: 503-471-3920
GUEST NAME:
ARRIVAL DATE:
NUMBER OF NIGHTS:
PLEASE BILL THE FOLLOWING CHARGES FOR THE ABOVE GUEST TO MY CREDIT CARD:
 ROOM AND TAX
 PARKING
 INCIDENTALS
 CATERING
 OTHER:______________________________________________________________
Following Guest Departure, please mail an Itemized Invoice to:
NAME:
COMPANY:
STREET:
CITY / STATE / ZIP CODE:
TELEPHONE:
PHOTOCOPY FRONT OF CREDIT CARD
AND ATTACH HERE.
PHOTOCOPY BACK OF CREDIT CARD
AND ATTACH HERE.
PLEASE NOTE THAT CARD WILL NOT BE APPROVED FOR AUTHORIZATION
WITHOUT A PHOTOCOPY.
SIGNATURE: ___________________________________ DATE:______________________
CREDIT CARD NUMBER: ________________________ EXPIRATION:_______________