Third-party Card Payment Authorization Form

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Person paying for somebody else applying to move into and currently lives in Apartel USA must fill out this form to authorize credit card payment as the third party.

Beneficiary *

Columbus Apartel

My full name is *

I am paying you the amount of *

by using my credit/debit card ending *

must be the last DIGITS of the card

for the person in the name of *

for the payable item named as *

weekly rent installment

partial weekly rent installment

reservation deposit

pet fee

other * Specify in next window

I understand all card payments incur surcharge and agree with it *

I confirm my unconditional agreement

I agree with conditions

Submit

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