Credit Card Authorization Form
Print, complete, sign and fax/mail this form PLUS a copy of the Cardholder's Photo I.D. to the agent who issues your ticket(s)
Booking Details:
1.  PNR or Reference Code (see email confirmation): ___________________________

2.  Departure Date: ___________________________________________________________

3.  Airline + Routing: ________________________________________________________

4.  Passenger Name(s): ________________________________________________________

    ___________________________________________________________________________

5.  Telephone: ________________________________________________________________

6.  Email Address: ____________________________________________________________
Payment and Credit Card Billing Details:
7.  Grand Total Amount (see email confirmation): ______________________________

8.  Card Number: __________________________________________ 9. Exp.Date: ______

10. Billing Address: __________________________________________________________

    City _____________________________________ State: ________ Zip: ___________

11. Name on Card: _____________________________________________________________

12. Customer Service Number on back of card: 1-800- ___________________________
I certify I am the bank authorized signer/cardholder for the above account and agree to the charges described herein, which will be charged to my credit card by the agent who issues my ticket(s).  I acknowledge that I am aware of the terms and conditions of the fare including non-refundable rules, changes are subject to fees, travel is not transferable, and other restrictions on the travel authorized, using my credit card as further described in the email flight confirmation I got for this booking.

_______________

_______________

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Signature Cardholder Date Place