Hotel Pre-Authorization Charge Dispute Form
Submit this form if you are a hotel guest disputing a pre-authorization charge. Please complete all required fields to help us process your dispute efficiently.
Full Name
*
First Name
Last Name
Reservation or Confirmation Number
*
Hotel Name
*
Check-in Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Check-out Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Amount Disputed (in USD)
*
Last 4 Digits of Card Used
*
Reason for Dispute
*
Please Select
Incorrect charge amount
Duplicate pre-authorization
Charge not released after stay
Unrecognized charge
Other
Detailed Explanation of the Issue
*
Upload Supporting Documentation (optional)
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