Ticket Order, Credit Card Authorization Form

AirTkt.com
117, W 9th St., Suite #307, Los Angeles, CA, 90015

TICKET ORDER, CREDIT CARD AUTHORIZATION FORM

PLEASE FILL THE FORM AND FAX IT BACK @ 213 955 5733 WITH COPY OF CC. AND ID.
Incomplete information or false statements shall be considered sufficient cause for denial of ticket

Please verify all information (Name, Date, Charge amount and flight details). Credit Card holder must Authorize and Accept the charges by Faxing the Credit Card Authorization Form.
This is to confirm that, in keeping with all applicable laws, I Agree and Authorize Third Party Payment for this Booking transaction and Accept charges below for Non Refundable Ticket on my Credit Card. I/we are instructing AirTkt.com to issue the following ticket(s) against the credit card listed below. It is expressly understood that this amount charged does not include or constitute any additional fees related to our acceptance of credit cards as a form of payment, unless permitted by law. We further represent the credit card holder stated below has authorized this transaction and that will indemnify and hold AirTkt.com. harmless with respect to these instructions.

Passenger Name(s):

Destination and Travel Date:

Cardholder s name as it appears on the credit card: Charge Amount:


HOME( ) - WORK( ) - FAX( ) -

Cardholder s C.C. billing address, including zip code:

STREET:
CITY:	STATE:	ZIP:

Credit Card Number: AX VI IK DS DC Exp. Date: Security Code:

Credit Card Issuing Bank Name & Telephone:

NOTE: Identification is required. Please provide photostat copy of the credit card and passport or Driver's license of the cardholder. By signing below, I acknowledge charges described hereon. Payment in full to be made when billed or in extended payments in accordance with standard policy of the credit card company.
I AM AWARE THAT THIS TICKET IS VERY RESTRICTED AND MAY BE NON REFUNDABLE. PENALTIES APPLY FOR ANY VOLUNTARY CHANGES OR CANCELLATION OF TICKETS AND MUST BE DONE BEFORE DEPARTURE DATE, IF NOT TICKETS HAS ZERO VALUE.

CARDHOLDER'S SIGNATURE: x ____________________________