Credit Card Authorization Form

 
CREDIT/DEBIT CARD PAYMENT AUTHORISATION
Please enter the correct information below for your Credit/Debit Card authorisation.
Cardholder Name
(As printed on the card)		   
Billing Address
(As displayed on your statement including any flat number etc.)		   



Post Code   
Card Number
(No spaces / Dashes)		   
Card Type
Start Date (If any) Month  Year  
Expiry Date Month  Year  
Issue Number (If any)  
CVC Number
(last 3 digits on back of card)
   
Amount to Pay
e.g, 28.45		 £   
Note: Service / Card surcharge - (UK Debit card: 0%, All others: 4%).
Total amount incl. surcharges £  
Telephone Number
(At least one number is mandatory)		 Day
Evening
Email     
(strongly recommended, so we can send you the receipt)
Declaration:
I authorise Classic Travel to charge my credit/debit card (details as above) as payment for the travel arrangements as booked. The details provided by me are TRUE and CORRECT. I confirm the card is registered to me at the address provided.

Signature required (if you are sending this form manually): ____________________

 
Booking Reference
(Provided by Classic Travel)
   
 
If you have any question or query about this form, please call us on +44 (0) 207 586 1234

 


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