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
-
American Express
Discover
JCB
Maestro-International
Maestro-UK
MasterCard
Solo
Switch
Visa-Debit
Visa-Credit
Other
Start Date
(
If any
)
Month
-
01
02
03
04
05
06
07
08
09
10
11
12
Year
-
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Expiry Date
Month
-
01
02
03
04
05
06
07
08
09
10
11
12
Year
-
2011
2012
2013
2014
2015
2016
2017
2018
2019
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. surcharge
s
£
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): ____________________
Check this box if you agree with the disclaimer.
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