CREDIT CARD AUTHORIZATION FORM - DOC 8 by crunchy

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									Please follow our instructions:
   Please Print out this Credit Card Authorization Form
   Fill and sign this printed form
   Photocopy your Credit Card – (Front & Back Side) and Passport
   Then fax the copy of your Credit Card and Passport together with this signed Authorization Form to
    our Fax no. (+844) 62813426 or scan and email us at info@viethoteltravel.com


CREDIT CARD AUTHORIZATION FORM
Name on the card            : _____________________________________________
Home address                : _____________________________________________
Nationality:                _____________________________________________
Date of birth               : _____________________________________________
Passport number             : __________________
Expiry date                 : __________________
I hereby authorize First Choice Company Limited in Hanoi, Vietnam to charge:
The total amount of         : ___________________________________ USD
Total Amount in word        : _____________________________________________
On my credit card           :Visa Card                           Master Card ___
Card number                 : _____________________________________________
Expiration date             : ___________________________________ (MM/YY)
SBJ/ CVV code               : ___________________________________
Travel services to book     : _____________________________________________
Date of services            : __________________________________ (DD/MM/YY)


Card holder’s Signature : _____________________________________________


*I have read and agreed with following cancellation terms:
• More than 14 days prior to date of services: The total deposit paid to us will be valid for one (1) year
from the date the deposit was received. During this time (365 days), the amount can be applied to other
tours and services if available. After one (1) year, the deposit amount is forfeited.
• Less than 14 days prior to date of service: Complete forfeiture of deposit, due to hotel/ boat charges we
incur for guest no-shows.

								
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