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 firstname.lastname@example.org 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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