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(501) 224-8051 / 1 (800) 422-8051

Credit Card Authorizaton Form

Upon arrival, we require a government-issued ID or drivers license in addition to a physical swipe of either a credit or debit card.

If you will not have a physical credit or debit card upon arrival -OR- if you would like to pay for a guest's stay, you may fill out the below form and send it to us prior to you or your guest's arrival date. Please note that in order for this form to be valid, you must:

  • Indicate whether the card will be paying for all charges or just room and tax. If only room and tax is selected, the guest will be required to provide a credit or debit card for incidental charges.
  • IMPORTANT: Provide a copy of the government-issued ID or drivers license associated with the card on the form in addition to front and back copies of the credit/debit card being used on the form.
  • button_download-credit-card-authorization-form

Please note that should the card on this form decline at check-in, the guest will be responsible for providing a credit or debit card for all charges.

Send completed form to:
fax to: (501) 221-7552

If your guest will arrive in time for the hotel to
receive the form via regular mail,

you may send the completed form to:
The Burgundy Hotel
ATTN: Reservations
1501 Merrill Drive
Little Rock, AR 72211

Need assistance completing the form? We're here to help!
(501) 224-8051 or toll-free at (800) 422-8051.