Credit Card Authorization Form


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CREDIT CARD AUTHORIZATION FORM

Please return this completed form by mail or fax to +1 510 790 0400

All information and payment details authorized by the cardholder for payment(s) towards specified payment type below, will be kept strictly confidential. We shall respect Cardholder privacy and safeguard against identity theft. We will never rent or sell any information supplied on this form. Lowfaretravel are authorized to process any payments specified.

IMPORTANT: If the cardholder is not the traveler please submit with this formal eligible copy of the front and back of the card and eligible copy of a valid government issued identification document such as passport /driver’s license / state issued ID.

Passenger Details

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Payment Information

Card Type  

Credit Card / Debit Card Number 

Cardholder’s Tel (please indicate with area code)

Card Holder Name 

Card Expiration Date 

Credit Card Verification Code

(For Visa/MasterCard, this is the last 3 digits on back of card on signature panel, after the Credit card number. For American Express, this is the 4 digits on front of card above the credit card number)

Amount Authorized
US$
plus any cancellation penalties imposed or additional services provided by Lowfaretravel. US$  

Billing and Contact Information

Credit Card Billing Address

   

   

In Lieu of my card imprint as required by Airlines Reporting Corporation section 8.4, I here by authorize Low Fare Travels to issue the above mentioned tickets and charge my credit card for the amount mentioned above. I will suport this authorization with copy of my credit card front and back and a federal ID. By signing below, i acknowledge full liability for the charge described herein. I am aware that these tickets are non-refundable and or subject to free for making changes.

NOTE: Tickets are non-transferable and name changes on tickets are not permitted. Most of the airlines are Non-Refundable in case of cancellation. Date and routing change is subject penalty of USD 350.00 or more plus fare difference if any applies on all tickets. Please note that your card statement may show single or multiple charges not to exceed the authorize amount.

Leave this empty:

Signed by admin Travel
Signed On: October 17, 2016

Signature Certificate
Document name: Credit Card Authorization Form
Unique Document ID: 3e1871454990ef1b2a6e305325fc907a20faecfa
Timestamp Audit
2016-10-06 19:51:07 PDTCredit Card Authorization Form Uploaded by admin Travel - info@lowfaretotravel.com IP 122.162.2.67