Credit Application Form: Welcome to Southern Maine Beach Rentals at Higgins Beach in Maine for property management and rental properties

Due to bank and credit card processing requirements, we are asked to have a signature on file for all credit transactions. Please print this page, complete the requested information and fax to 207-727-6669 or mail to P.O. Box 196, Hollis, ME 04042, USA.

Please provide your contact information:

Name:

Email:

Address Line 1:

Address Line 2:

City:

State/Prov:

Country:

Zip/Postal Code:

Phone Number:

Please provide your billing information:

Credit Card

MASTER CARD

VISA

Credit Card Number:

Printed Name:
(as it appears on credit card)

Expiration Date:

Please indicate
what are you paying for:

Beach House Rental

Rental Items

cottage address____________________ rental date(s)_________

I agree to pay the amount of (US$):

We will confirm the charge details by email after charging your card.

Signature

Refund Policy

Guest is financially responsible for the specific time they have reserved. Cancellations by April 30th will result in a 50% refund. After April 30th the guest forfeits their entire payment. Southern Maine Beach Rentals will attempt to rebook the date and if successful, will refund all monies minus a 25% cancellation fee on the total amount.

Any additional comments or questions: