Payment Plan Authorization

Payment Plan Request

To establish your payment plan please enter your information below.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Trip Destination*
Trip Date*
Date to charge first payment*

MonthDayYear
Date
Date to charge last payment*

MonthDayYear
Date
Please charge my card*

Once a monthOnce a weekEvery other weekOther
Each designated period, please charge my card this amount: *
Type in the amount you wish to pay.
Last four digits of the credit card number for your payments*
What day of the month would you like your card charged if your card is to be charged monthly i.e. 6th, 15th etc. (Please note: Due to weekends, holidays and work schedule, we cannot guarantee you payment will be charged on this date every month.)
Should you prefer to use a card we do not have on file for you, please go here to add it. You will need to Confirmation NUmber that is listed on the upper right corner of your Confirmation-Receipt.
Comments (Please do not include your credit card information here.)
By submitting this form, you certify that you are the cardholder and are authorizing Ebony Vacations to charge the listed amounts to the credit card as indicated.

You certify that you have verified that all information contained in the confirmation you received is accurate. You certify that where indicated, payments/deposits may not be refundable.

This charge will be applied by Ebony Vacations to your reservation. If there are any issues, we will get back to you. Please note that you will see a charge from Ebony Vacations on your credit card statement. Payments may take 3-5 business days to fully process and be reflected on your statement.

If you selected a day of the month for your card to be charged, circumstances may not allow us to charge your card on that date. Your payment will be charged as soon as possible on the next available date.

I authorize Ebony Vacations to use the above information to charge my credit card the stated amount on the stated dates.

By adding your signature, you indicate that the above amounts and dates are correct, you authorize Ebony Vacation to charge your credit card for the specified amount on the specified dates, and you agree to the terms and conditions.
Signature

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Payment Plan Request