Sudha Travels, Inc
P.O Box : 238, Gotha, FL 34734-0238
Tel: 718 448 4433 Email: Sudha@Sudhatravels.com
Credit Card Holders Authorization
(please print this form, fax/email the filled form to us)
In lieu of my credit card imprint, I ___________________________________________________________________
( Name as shown on credit Card)
herby authorize Sudha Travels, Inc to charge these to my ___________________________________________________________________
(Name of the Credit card Company)
Account #____________________________________________________, Exp Date _____________, Cvv Code_________.
In the amount of USD_______________, for payment of transportation of myself and or my family members
(Surname /Given Name as per Passport) DOB (M/F)
1._____________________________________________________________________________________________________________________
2._____________________________________________________________________________________________________________________
3._____________________________________________________________________________________________________________________
4.______________________________________________________________________________________________________________________
5.______________________________________________________________________________________________________________________
for itinerary as follows __________________________________________________________________( Complete Routing).
My Billing Address as per credit card Statement: Telephone Numbers :
________________________________________________ USA Cell: ____________________________________________
________________________________________________ USA Res: ____________________________________________
Email:_____________________________________________ India Tel :_____________________________________________
Note: Please provide clear copies of credit card (front & back), Driver's license and proof of billing address if different from driver's
license.
By signing below, I acknowledge the charges described above. Payment in full to be made when billed or in extended payment. In accordance with
standard policy of company issuing the card, I acknowledge that the tickets are non-refundable.
X___________________________________________________________________(Signature of Card Holder)
Please note payments made to purchase airline tickets using credit card are inclusive of service charges as separate transaction in
some cases, but will not exceed the authorized amount on credit card Authorization form .
Editable CC Form Link