Authorization Form

Arrival Date*
Reservation Ref
Surname*
Name*
Email
Total Amount Authorized* (EUR)
Card Type*Nexi (Visa,V-Pay,Mastercard,Maestro,Jcb,UnionPay,PagoBancomat)American Express
Authorization Type*As a guaranteeFor the payment
Credit Card Number*
CVC*
Month*—Seleziona un'opzione—123456789101112
Year*—Seleziona un'opzione—20222023202420252026202720272028202920302031203220332034203520362037203820392040

I certify to be the cardholder and signer of the credit card reference above and I authorize Barocco Hotels s.r.l. to charge the above amount on the indicated credit card.*

I have read and agree privacy policy and consent to the storage of my data in your archive as established by the European regulation for the protection of personal data n. 679/2016, GDPR.*

Please, attach Owner's ID card.
* (required)