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Trip Payment Form
Use this form to make a payment at anytime.
6
Questions
START
1
Lead Traveler's Name
*
This field is required.
Name of the lead traveler on the booking
First Name
Last Name
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Enter
2
Lead Traveler's Email Address
*
This field is required.
Lead email address associated with the booking
example@example.com
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Submit
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Enter
3
Current Booking/Invoice Number
*
This field is required.
The booking or invoice number provided on your original trip confirmation.
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Enter
4
Signature Authorization
*
This field is required.
By signing this form, you confirm that you are the authorized cardholder with the necessary permissions to use the provided card. Please be aware that a 4% convenience fee will be added to the payment amount. It's important to note that GDS Travel Solutions will not assume liability for any transaction-related issues, including potential chargeback claims.
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Enter
5
Cardholder's Name
*
This field is required.
If the person making the payment is different than the lead traveler, enter their name here.
First Name
Last Name
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Enter
6
Payment Being Applied
*
This field is required.
Use the dollar increments to sum the amount of the payment being made today.
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( X )
My Bag
0
My Bag
Back to list
Great Product Name
$20
Quantity:
1
Size:
Small
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Great Product Name
$20
Quantity:
1
Size:
Small
Remove
Edit
Great Product Name
$20
Quantity:
1
Size:
Small
Remove
Edit
Great Product Name
$20
Quantity:
1
Size:
Small
Remove
Edit
ORDER SUMMARY
Convenience Fee
USD
Subtotal
USD
Total cost
USD
$1 Dollar Increments
Select the number of dollars being paid (ex, for a payment of $521, you will select, 1x$500, 2x$10, and 1x$1)
$
1.00
+
Remove
Edit
Back
Quantity
$5 Dollar Increments
Select the number of dollars being paid (ex, for a payment of $521, you will select, 1x$500, 1x$20, and 1x$1)
$
5.00
+
Remove
Edit
Back
Quantity
$10 Dollar Increments
Select the number of dollars being paid (ex, for a payment of $521, you will select, 1x$500, 2x$10, and 1x$1)
$
10.00
+
Remove
Edit
Back
Quantity
$20 Dollar Increments
Select the number of dollars being paid (ex, for a payment of $521, you will select, 1x$500, 1x$20, and 1x$1)
$
20.00
+
Remove
Edit
Back
Quantity
$50 Dollar Increments
Select the number of dollars being paid (ex, for a payment of $521, you will select, 1x$500, 2x$10, and 1x$1)
$
50.00
+
Remove
Edit
Back
Quantity
$100 Dollar Increments
Select the number of dollars being paid (ex, for a payment of $521, you will select, 1x$500, 2x$10, and 1x$1)
$
100.00
+
Remove
Edit
Back
Quantity
$500 Dollar Increments
Select the number of dollars being paid (ex, for a payment of $521, you will select, 1x$500, 2x$10, and 1x$1)
$
500.00
+
Remove
Edit
Back
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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Enter
7
Unique Session ID
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Enter
Should be Empty:
Anytime Trip Payment Form
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