:::: Rio Nuevo Lodge -- Reserve -- Credit Card Authorization--

CREDIT CARD AUTHORIZATION FORM
Date
I
	authorize to charge my Visa Card or Master Card, number
Issue date
Expiration date
In the amount of:
Bank code
	(usually the first four digits of your card)
	I agree to pay the amount here authorized, even though I have not signed the original charge note or voucher.
Date of birth
Passport number
Signature
For office use only:
Authorization number