AUTHORIZATION TO CHARGE ON CREDIT
CARD |
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| Note: Please fax a photocopy of your Credit Card (front and back), and a photocopy of the card holder's Passport or State ID (Driver's license) to Fax : +1-302-261-7117 along with this form. | |
Master Card
Visa |
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| Passenger Name: | |
| Card Holder Name: | |
| Card Number: | |
| Card Expiration Date: | |
|
CVV No: (The CVV No. appears on the signature strip of your credit card) |
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| Total Amount: | |
| Billing Address: | |
| Billing City: | |
| Billing State: | |
| Billing Country: | |
| Billing Zip: | |
| Home Phone: | |
| Office Phone: | |
| Fax Number: | |
| Remarks: | |
In
lieu of my credit card imprint, I
, hereby authorize The Swiss Holidays and/or their representative
to charge my above Credit Card for the amount shown above. By signing
below, I acknowledge the charges described above. I understand that
the above amount is subject to cancellation policies which have
been understood by me and undertake not to take a charge back for
the above amount. |
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| ________________________ Card Holder's Signature |
|
| Date: ___________________ | |
