Sudha Travels, Inc

1751 Victory Blvd, Staten Island, NY 10314

Tel: 718 448 4433      Fax: 718 448 3737    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)

hereby 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

Name & DOB of passengers traveling with you as in passport.

1._______________________________________________________________________________________________

2._______________________________________________________________________________________________

3._______________________________________________________________________________________________

4._______________________________________________________________________________________________

5._______________________________________________________________________________________________

 for itinerary as follows __________________________________________________________________( Complete Routing).

 

My Billing Address as per credit card Statement:                                         Telephone Numbers:

______________________________________                                        Cell: ______________________

______________________________________                                        Res: ______________________

_______________________________________                  Email:__________________________________________

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)