RENTAL PAYMENT & CREDIT CARD AUTHORIZATION FORM STATEMENT OF UNDERSTANDING
For the following Rental: Cocoa Beach Cottage - 3602 Ocean Beach Blvd Cocoa Beach, FL
Owners: Michael/Monica Ouellette 5000 Ocean Beach Blvd - Unit C5 Cocoa Beach FL 32931: 321-750-8657; 518-461-0222
Email: CocoaBeachVacationRental@gmail.com

CREDIT CARD AUTHORIZATION FORM AND STATEMENT OF UNDERSTANDING


I, _________________________am renting at 3602 Ocean Beach Blvd Cocoa Beach, FL Total amount including rent, tax and clean fee: $_______________ from:___________________to ___________________ No. of people in Party_____Once paid in full, we will send instructions and directions.  

I, hereby authorize Monica & Michael Ouellette, to
    odeduct $_________ rent from the above by credit card.  
    odeduct $100 security hold authorization - there will be no deduction unless careless damage to the         vacation home that I/or any of my group have caused while in the home stated below, or missing         inventory.  

______________________________________________
SIGNATURE OF CARDMEMBER

____________________________________
DATE SIGNED

CLIENT’S NAME: ________________________________________________

ADDRESS:________________________________________________________

PHONE:____________________________________________________

EMAIL: _____________________________________________________


BUSINESS PHONE:________________________________________________


VISA or MASTERCARD NUMBER__________________________________________


NAME AS IT APPEARS ON CARD_____________________________________


EXPIRATION DATE:_______________________________________________


3 DIGIT CODE: _________________________

Cancellation Policy: If cancellation is made within thirty days of arrival date, then half of the total rental amount will be refunded. Travel insurance can be purchased at reasonable rates by your own ins. Co. or an online company.
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