Aloft Miami Brickell 1001 SW 2~, Miami, FL 33130 T: 305 854.6300 F: 305 854.6301 Elon This form has been created in order to allow you to have third party expenses charged to your debit’ credit card. Please provide all the information requested below to ensure prompt processing of your application. We ask you please sign and date the form before submission. Please fax the completed form to the Director of Sales at (305) 854-6301, Please call (305) 854-6300 to inform the property the form has been faxed to ensure the form is retrieved in a timely manner. Do not send photocopies of the credit card with this form, as this is against credit card company policies. Dear Sir or Madam, CARDHOLDER INFORMATION: CREDIT CARD #:_4SQ%_SQCO_ ONL E319 exp pare: 6t/ 2S CARD TYPE: AMEX [J MASTERCARDL] VISA DX] DINERS CLUB] DISCOVER] ACCOUNT TYPE: PERSONAL ><. CORPORATE: ICOMPANY NAME: GAQCiA NAME AS IT API ON CARD: MAGIA ANODE rioRiug _ ADDRESS, CITY, STATE, ZIP. seis ANE ; NATHQENS 279 _BTAL ~ SALVA ~AQGeNT NA ~ YHOO PHONE NUMBER: S4& S29U URle GS. FAXOR ALTERNATE NUMBER: GUEST INFORMATION (REQUIRED): GUEST NAME: GOYTA KUO SANTIMGOGROUP OR ORGANIZATION, CHV. STATE, ZIP TORDABONOS DF" Bo WORE ~ SRUTA = REGEN R= GOO PHONE NUMBER: Qi ESS 9 GYE TAN OR ALTERNATE NUMBER ms CONFIRMATION: DAILY ROOM RATE ARRIVAL DATE: 25 [OS DEPARTURE DATE: _2@ 105 ]2O%O RELATION TO CARDHOLDER: We GUEST SIGNATURE: ‘understand that should there be an issue with boeing used To sell my account, forall expenses incurred during my stay. Departure date cannot be extended unless a new authorizati be responsible mn form is complete. APPROVED CHARGES: ye ALL CHARGES nA ROOM & TAX ce Grr siior CATERING, FRB TELEPHONE LOCAL VALET LAUNDRY = TELEPHONE LD BEVERAGE. PARKING. SELIST) E PLE cose ites ee oeretna ABOVE LISTED CHARGES, NOTE THE MAXIMUM AMOUNT AUTHORIZED HERE $_ 1F-YOU REQUEST A LIMIT FOR TI 1 certify that all the information above is complete and accurate. I hereby authorize Aloft Miami Brickell to collect payment forall charges as indicated in the rat and approved charges section of this form by processing a credivdebit card listed above, also understand a new form will need to be completed if guest wishes to extend hisher stay The ‘undersigned also understands and agrees that the above credit card may be charged in advance for the estimated amount authorized. Any remaining balance used willbe credited back to the Credit Card, NaMEOF CARDHOLDER: MORUO HARIA AMDLEA sicxatureorcarpnower (Larllos pire) O5 [2020 Please ensure that you send this form along with a copy of the card being used (front and back) and a copy ofthe 1D ofthe cardholder.