Subject: 3rd Party Authorization

From: Palace Station Hotel & Casino (PSreservations@stationcasinos.com)

To: tennybobo@att.net;

Date: Monday, November 28, 2016 5:44 PM

3RD PARTY CREDIT CARD AUTHORIZATION

GUEST INFORMATION:
The reservation for the guest mentioned below may be charged to my credit card according to my
instructions provided. I guarantee full payment on the account as described.

MINORS WILL NOT BE ALLOWED TO CHECK INTO THE HOTEL WITHOUT AN ADULT WHO IS 21 OR
OLDER.

Name of Guest: Sharonda Williams

Arrival Date: 01/02/2017
Departure Date: 01/03/2017
Confirmation Number: VLGYC
Hotel: Palace Station

CREDIT CARD INFORMATION:

The credit card below will be charged in full upon receipt. If you indicated payment for
incidentals, your card will also be charged at check out to cover these charges.

Requests must be received 72 hours prior to arrival. If it is less than 72 hours before the
guest arrives, please contact the hotel management team directly.

Credit Card Number:_______________________________ Exp:_______

Card Holder Name:________________________________________

Billing Address:_______________________________________________

Phone Number:______________________________________

CHARGES TO BE BILLED:

(Please choose only one option):

All Charges:____ Room, Tax & Resort/Hotel Service Fee:____ Room/Tax Only: _____

DEPOSIT
All Station Casinos properties collect a refundable security deposit upon check in (Red Rock/Green
Valley Ranch $100 per day/all other properties $100 per stay). Deposits are returned at
departure minus anything charged to the room during the stay.

* I agree to be held personally liable in the event that the indicated person fails to pay for any
additional charges incurred during their stay. I further agree that any disputes or requests for
copies of charges must be made within 5 days after the departure date.

Authorized Signature:______________________________ Date:_______

Please fax the completed form to (702) 495-3310. Authorization forms may not be sent via email.
Call (702) 495-3912 with questions.