VK Travels

VK Travels AUTHORIZATION FORM I __________________________________________ hereby authorize VK Travels to charge my Credit Card / Debit Card for travel purpose. Card No. : _______________________________ ¾ digit security code from back of card: ________ (3 digit for Visa/ MasterCard from back of card – 4 digits for Amex from front of card) Card Type: Master Card / Visa / American Express (Circle One) Expire Date: __________________________ Amount in USD: ____________________________ Bank of Issue: ____________________________________ Customer Service phone no from back of credit card: _____________________________ Driving License No.: _____________________ State of Issuance: ______________________ Card Holder’s Name: ______________________________ Billing Address: __________________________________ ___________________________________ E-Mail Address: ___________________________________ Best US Mobile Phone: _____________________________ Fax: _________________________ Best India Contact nos. : __________________________________ Is the Card Holder travelling? YES NO I _____________________ (card holder) agree to pay the travel expenses for _________________ (name of person traveling) with my credit card, details of which are listed above. I understand the Refund / Cancellation penalties that have been explained to me relating to this type of purchase and will be applicable and acceptable to me. PLEASE FAX THIS COMPLETED FORM WITH CREDIT CARD FRONT AND BACK AND A COPY OF PICTURE ID TO 1-510-573-5057 or SCAN AND EMAIL IT BACK TO vktravels@vktravels.us _______________________________ _______________________ Signature of Card Holder Date 41446 Beatrice St., PHONE 1-510-573-4153 Fremont, CA 94539 FAX 1-510-573-5057 EMAIL WEBSITE 1 vktravels@vktravels.us www.vktravels.us