Credit Card Authorization Form

Credit Card Authorization Form
Wall 2 Wall Credit Card Authorization Form
TRAVEL PURCHASE AUTHORIZATION For Non-Website (Inteletravel.com) Purchases. Thank you for your purchase. InteleTravel.com & Wall 2 Wall Travels is pleased to confirm the following travel arrangements. To complete your transaction and confirm your arrangements, your signature on this authorization is required. This form is NOT required for electronic purchases you complete yourself on our website, www.InteleTravel.com, https://janetwall.inteletravel.com or its affiliates. Charges are payable ONLY to InteleTravel.com or the hotel, resort, tour operator, cruise line or other travel suppliers.

Independent Travel Advisors may not accept and process charges through any other account, or accept checks, cash or other forms of payment.

For security of advisor and client we must have copy of identification and copy of front and back of customer credit card being used.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
I understand my information will be saved for future transaction on my account. I authorize InteleTravel.com, this travel supplier and/or Janet Wall to charge my credit card for the authorized amount below. (YES or NO)*
Credit Card Number*
Card Type*
CVV / CCV*
Authorized Amount to Charge*
I have ACCEPTED and authorized the travel purchases above, including travel insurance, and I am aware the insurance premium is not refundable.

I also acknowledge that I have read/reviewed my quote and if I must cancel my trip, I may receive a travel voucher and not a cash refund, minus the insurance premium, depending on the vendor being utilized to book my accommodations.
Signature*

Powered by Jotform SignClear
Date of Signature*

MonthDayYear
Date
This authorization is for the following Travel Arrangements.
(INTERNAL USE ONLY)
Vendor

Booking Number

Dates of Travel

Lead Traveler

Passenger #2
Should be Empty:

Credit Card Authorization Form

Wall 2 Wall Credit Card Authorization Form