Houston 365 LLC CREDIT AUTHORIZATION

Email: info@houston365.net ~ Phone: 713-804-6600

The process of this application requires a Signature.

Today Date

In Lieu on my credit card imprint, I

Authorizing to houston 365 LLC charge the credit card listed below for services provided today and or any future services.

Name of Card Holder

Credit Card Billing Address

Street:

City:

Street:

Zip Code:

Country:

Card Number

Card Expiration Date

Security Code (CVV):

Home / Office Phone Number

Fax Number:

Cell Phone Number

Authorized Passenger

If other than Card Holder

2nd card, if necessary

Name of Card Holder

Credit Card Billing Address

Street:

City:

Street:

Zip Code:

Country:

Card Number

Card Expiration Date

Security Code (CVV):

Home / Office Phone Number

Fax Number:

Cell Phone Number

Authorized Passenger

If other than Card Holder

By signing below, I acknowledge charges made by houston 365 LLC . In the event of passed cancellation deadline, I authorize Houston
365 LLC to charge the full reservation fee. I read and agreed to all the cancellation guidelines (terms and conditions) that apply to
my reservation. I understand that I'm liable for any late fees, cancellation fees, taxes and other charges. I will not dispute this charge.
Payment based on rates provided by Houston 365 LLC as well as other authorized charges made to be in accordance with the issuing
card policies. I affirm my obligations under the card member's agreement.

Client's Signature

Print Name

Date

Notes/Comments: