CREDIT AUTHORIZATIONTravel Support Center Fax to the number you were given. Please Fax to: Our Main Office (619) 435-1104 Unless instructed differently, please fax the following items: (1) THIS AUTHORIZATION FORM (2) PHOTOCOPY OF CREDIT CARD (BOTH SIDES) and (3) PHOTOCOPY OF DRIVER'S LICENSE OR PASSPORT Please include your six-digit reference code:______________ Fill in CREDIT CARD TYPE: () Visa () Master Card () American Express () Discover Card Card Holder's Name:______________________________ Credit Card Number:______________________________ (Print Clearly) CVC Number:__________________ (last 3-4 digits of number on back or card) Expiration Date:______/______ Bank Phone (see back of card):___________________ Billing Address where you receive credit card statements: _________________________________________________ _________________________________________________ Card Holder Phone:_______________________________ Card Holder Work Phone:__________________________ Mobile Phone:____________________________________ I, the card holder,________________________________ have read and understand the terms and conditions of Travel Support Center and agree to them completely (click here to review the Terms. I authorize Travel Support Center or its affiliated ticketing agency to charge in full the amount of $________________ for travel related services for the following passenger(s): _________________________________________________________________ _________________________________________________________________ Sign below that you agree to the conditions on this form. CARD HOLDER SINGATURE:_____________________________________ DATE:_______________________ Shipping Address for paper tickets or e-ticket receipts, if mailed: ________________________________________________ ________________________________________________ |