Credit card authorization Form

I , herby authorize ZB Hospitality Inc. (RentKosherPlaya.com) to charge my credit card for charges in association with Condo damage, late check-out, "Kashrus" violation and Resort violations/damages.

$500USD (US Dollars) or Canadian equivalent (whichever amount is greater at time of charge) - Total amount to be charged

Arrival date

Departure date

Card Type
VisaMaster CardAmerican Express

Name as it appears on card

Card number

Expiration date

CVV

Billing Address

City

State/Province

Zip/Postal Code

Cell Phone

Home Phone

By submitting this form, you give ZB Hospitality Inc. (RentKosherPlaya.com) permission to debit your account for the amount indicated on or after the indicated date. This is permission for a single transaction only, and does not provide authorization for any additional unrelated debits or credits to your account.

Cardholder's Full Name:

Submission date:

I authorize the above-named business to charge the credit card indicated in this authorization form according to the terms outlined above. This payment authorization is for the goods/services described above, for the amount indicated above only, and is valid for one-time use only. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company; so long the transaction corresponds to the terms indicated in this form.