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| Credit
Card Authorization Form |
Please print the Credit Card Authorization form.
Printable Version
Once you have filled out the necessary information and
signed the form, please fax it back to us at 484.233.1004.
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| Contact & Reservation Information
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| Your Name |
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| E-mail Address |
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| Contact Phone |
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| Name of Villa |
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| Reservation Dates |
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| Credit Card Information |
| Name on Credit Card |
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| Credit Card Type |
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| Credit Card Number |
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Security Code
(On the back of the card.) |
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| Credit Card Expiration Date |
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| Credit Card Billing Address |
| Street Address |
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| City |
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| State/Province |
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| Zip/Postal Code |
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| Amount to Charge My Credit Card |
| Amount to charge your card |
$ |
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| I authorize Caribbean Villa Hideaways
to charge my credit card in the amount shown above. And
I agree that I have read and agree to the Terms and Conditions
of Villa Rental. |
| Signature: |
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| Jamaica Travel Information |
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