Credit Card Authorization

Credit Card Authorization

for additional charges
Who is your advisor?

KatieTeresaDebby
Name on Credit Card

First NameLast Name
Date to Charge

MonthDayYear
Date
Trip Date

MonthDayYear
Date
Amount $?
Charge is for? (Supplier)
I approve my travel advisor charging my credit card for additional purchases related to the trip. This is according to the Terms/Conditions/Cancellation policy that my credit card company has.
Signature

Clear
Should be Empty: