Credit card charge authorization form

Please fill out this form and scan/fax/mail it back to us along with copies of your credit card front and back and a picture ID of the cardholder (this is for your own protection). All information provided will be treated strictly confidential.

I, _____________________________________ (full name of cardholder as per passport) authorize Linh's Travel & Tour Services and or its authorizing consolidator agents to charge my credit card # ____________________________ and 3 digits security code is ___________ (back of card) which expires on _____/_____/____, for the amount in USD $_________towards the purchase of airline tickets or services for myself and/or _________________________________________________ (full name of all passenger(s) as per passport if other than cardholder)

Print Cardholder Name: _________________________________________________

Address of Cardholder: __________________________________________________

City: _________________

State: ___________

Zip Code: _________

Departure Date: ___________ Return Date: ___________ From: ___________ To: ___________

Frequent flyer #: __________________ Seat / Meal preferences: __________________

Tickets to be sent to above billing address: ____ Yes ____ No

(If NO, please provide the mailing address below)

____________________________________ E-mail:____________________________

____________________________________ Phone:_____-______-______ Cell: _____-______-______

Tickets to be sent by:

___ Overnight services (add $20.00) ___ Priority Mail (add $10.00)

___ Regular Mail (we are not responsible for lost or any delay documents)

x ___________________________________________________ Date:_________________

Signature of Cardholder (as it appears on credit card) authorized amount.

Note: Final documents will not be released unless Linh's Travel & Tour Services receives all signed credit card authorization form. NO EXCEPTIONS WILL BE MADE.


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