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CHAR'S DESTINED VACATIONS LLC

Charnetta Upshaw |248-671-3672 | Charsdestinedvacations@gmail.com
Client Details:
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail*
example@example.com
Date of Birth*

MonthDayYear
Last four digits of the card used for payment*
** To protect your confidential information, you can not provide your full credit card number in this form. You will be contacted by your agent to provide your credit card number for payment. A copy of your photo ID is required along with this form **
Upload Your Identity Card: A copy of the front of your Driver License or State ID is required by Archer Travel Service, Inc. and Char's Destined Vacations LLC for all transactions.*

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This form is provided to you by an independent travel agent affiliate of Archer Travel.

Seller of Travel: CA 2001330-10, FL 35395
Signature Required (Signature must match your signed identification)*

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Payment Authorization