Credit Card Authorization

Credit Card Authorization

for additional charges
Who is your advisor?

Katie Teresa Debby
Name on Credit Card

First Name Last Name
Date to Charge

Month Day Year
Date
Trip Date

Month Day Year
Date
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: