I hereby authorize the Omni Shoreham Hotel to apply costs for the above listed items services to the 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the Name of Guest or Organization at the top of the form. This identifies who is authorizing the charges.
3. Next, print and fill in the Cardholder Name and Phone Number. Ensure accuracy as this information is crucial for verification.
4. Select your credit card type by checking one of the options provided (e.g., Visa, MasterCard).
5. Input your Credit Card Account Number and Expiration Date in the designated fields.
6. Describe the services you are authorizing charges for in the Description of Services section.
7. Fill in the Date of Function to specify when these services will be rendered.
8. Sign and date where indicated to authorize charges. Ensure that your signature matches that on your credit card.
9. Provide your address details where statements should be sent, including Name, Company Name, Address, City, State, and Postal Code.
10. Once completed, fax your form to 202-756-5120 Attn: Jeff Horton, CMP CHDT for processing.

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