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)