CTB Credit Card Authorization Form

Cleo White, Travel Agent

Cruise Travel Boss | 443-991-0148 | cruisetravelboss@gmail.com
Credit Card Authorization Form

Cleo White
The Independent Travel Advisor listed above is pleased to confirm your travel arrangements. In order to finalize your arrangements, your payment information and signature on this credit card authorization form is required. Please note that charges are payable ONLY to InteleTravel.com or the specific travel supplier such as the hotel, resort, tour operator, cruise line, etc. Independent Travel Advisors may not accept and process charges through any other account, or accept checks, cash or other forms of payment.
The cardholder listed below authorizes charges for:
Travel Itinerary Descriptions:Trip Name
Dates of Travel: Departure Date Return Date
Passenger Names: Passenger Name(s)
Card Holder Information
Card Holder Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Type of Payment:*

One Time ChargePay deposit amount below and balance to be paid in increment(s) until paid in full by due date
Charges To Be Applied On:*

MonthDayYear
Date
Total Amount Authorized (USD):*
Description
Credit Card Type:*

VisaMaster CardAmerican ExpressDiscover
Credit Card Number (Last 4 Numbers)*
Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
For security reasons, we only allow the last four digits of your credit card to be recorded. Please select the best date and time that we may contact you to obtain your complete credit card information. We must obtain this information before we can complete your reservation.
Select Date/Time*
I hereby authorize the Travel Advisor listed above, InteleTravel.com, or the hotel, resort, tour operator, cruise line or other travel supplier that my booking is through to charge my credit card for travel reservations.
Cardholder Signature

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Date

MonthDayYear
Date
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Cleo White, Travel Agent

Credit Card Authorization Form