VEP Associates Professional Services, LLC
VEP Associates Travel
CREDIT CARD AUTHORIZATION FORM
I give authorization to VEP Associates Professional Services, LLC dba VEP Associates Travel to charge my credit card for the agreed services.
This form is used to process a payment or monthly payments per the amount indicated below and the option to purchase vacation protection. Recurring monthly Payment options can be selected below.
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THIS PAYMENT COVERS THE FOLLOWING GUESTS
BILLING ADDRESS
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Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
PAYMENT OPTIONS
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CONTACT INFORMATION
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Payments will be processed by VEP Associates Professional Services / VEP Associates Travel or directly with the trip's supplier
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Signature
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Date
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Month
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Day
Year
Date
COMMENTS:
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