PAYMENT AUTHORIZATION FORM

I
Having my billing address at
City:
State:

Zip:

Tel:

I hereby authorize ANDALOUS EXPRESS TRAVEL to charge my credit card for the travel related services as described below:

Airline ticket(s) From

To
*Departure Date

*Return Date
*Credit Card # : (DISCOVER NOT ACCEPTED)
*Exp : /
*In the Amount of $:

Total Number of passengers

Passenger's name	date of birth

*a copy of card holder credit card and picture id is required. + how can i upload the pictures

card holder credit card

picture id

help me please

By signing below, I agree that I’ll pay for all such purchases and will not hold ANDALOUS EXPRESS TRAVEL responsible for any of these actions pursuant to this credit card authorization.

I am aware of the applicable restrictions and /or penalties related with the purchased tickets as shown.

******* PLEASE NOTE THAT SOME TICKETS ARE NON-REFUNDABLE AND NON- CHANGEABLE PLEASE ASK YOUR AGENT BEFORE SIGNING THIS FORM *******

PAYMENT AUTHORIZATION FORM

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