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Card Authorization

In lieu of credit card print, I notify the authorization, reservationcentre.us to deduct my VI / MC / DS / AX / DC (credit / debit card) the amount as state below for the transportation payments for mine and/ or other passengers. Details are mentioned 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:

Amount to be paid:

Address 1:

Address 2:

City:

State:

Country:

Zip Code:

Contact Details

Work Phone:

Home Phone:

Cell Phone:

Email Id:

Driving Licence Number:

Passport Number:

Attachment:

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.)