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Card Authorization

In lieu of a credit card print, I give permission to charge the amount stated below using my VI / MC / DS / AX / DC (credit/debit card) for journey expenses for myself and/or those traveling with me. The following details are given below.

Credit Card Authorization Form

ReservationCentre Booking Reference No. (PNR) *:

Name of Sales Person *:

Customer Name *:

Card Holder Name as on card *:

Credit / Debit Card Number *:

Credit / Debit Card Expiry Date *:

Cvv No *:

Amount to be paid *:

Address 1 *:

Address 2 (optional):

City *:

State *:

Country *:

Zip Code *:

Contact Details

Billing Phone *:

Billing Email Id *:

Attachment (optional):

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I / We confirm that I / We have read the Terms and Conditions online and accepted all the Terms and Conditions governing our purchase of an air ticket or any other service from reservationcentre.us. In addition, I / We also confirm that I / We have verified that all information entered during the reservation process is accurate. I / We also acknowledge that this will serve as your electronic signature. (Please check the box to continue.)