ATIflights.com Credit Card Authorization Form

1 - PRINT this Credit Card Authorization Form

2 - FILL IT OUT and SIGN IT

3 - Attach copy of the following documents: credit card, credit card holder's Picture ID and Lead Travelers passport.

4 - FAX it to ATIflights.com at 1-866-336-5276

I have read and understood the Terms and Conditions as listed on the web site. I agree to adhere to them by signing below. Third party payments must include copies of credit card's front and back. Plus ID of the credit card holder.

Booking Number:

 

Departing Date: (mm/dd/yy)

 

 

 

All Passengers Names as they Appear on Passports:

1-

2 -

3-

4-

Card Holder Name:

 

 

Please be advised that your credit card is subject to be charged in parts for the amount authorized below.

Card Holder Billing Address:
(as shown on credit Card statment)

Address:

City:

State:

Zip: 

Card Holder Home Phone Number:

Credit Card: (Check one)

 

American Express

 

Discover

 

Visa

 

Master Card

Credit Card Number:

Credit Card CCV Number:

 

 

CCV Number? click here for more information

Credit Card Expires: (mm/yy)

 

 

 

 

Telephone Number:

Work:

 

Home:

 

Credit Card Issuing Bank or issuer name:

 

Credit Card Issuing Bank Toll free number:

 

Final Payment:

$  

for Booking#(s) 

 

If we cannot confirm services as per quote, we will send you a new invoice/confirmation form. If the final amount changes we will require a NEW credit card form with the adjusted amount.

Card Holders Signature:

 

Date(mm/dd/yy): 

Travel Insurance:

I have been advised of and chosen to

 

ACCEPT or

 

DECLINE

Travel Insurance.

For Paper Tickets Only

Shipping Address:
Documentation is sent by FEDEX requiring a signature upon receipt. We do not ship to PO BOX addresses.

Company or Name:

Attention/ Care of:

Address:

City:

State:

Zip: