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CARDHOLDER'S CREDIT CARD CHARGE AUTHORIZATION

Please fill in all the fields, Print the Page, and Fax it to (405)787-6977.

American Express

Visa

Master Card

Discover

Card Holder Name:

Card Number:

Card Expiration Date:

Total Amount (US$):

Passenger Names:

My billing address is:

Home Number:

Office/Cell Number:

Fax Number:

Card Holder Signature:

 


Today's Date:

 

In lieu of my credit card imprint, I , hereby authorize Asian Travel, Inc and/or their representative to charge my Credit Card for the amount shown above. By signing below, I acknowledge the charges described above. Payment in full to be made when billed or in accordance with the policy of the company issuing the credit card. 

Instructions: Please Fax this form, a photocopy of the Credit Card (front and back), and a photocopy of the card holder's Passport or State ID (Driver's license) to (405)787-6977

Note: After we receive sign credit card form, if any reason you cancel or change of your tickets, you may have to pay the penalty fees. Please contact us for full terms and conditions.

Thank You For Choosing 
ASIAN TRAVEL, INC.
7300 N.W.23rd St., Suite # 106, Bethany, Oklahoma 73008
Tel:(405) 495-TOUR (8687) * Fax:(405) 787-6977