Card Authorization

In lieu of a credit card print, I give permission to charge the amount stated below using my VI / MC / DS / AX / DC (credit/debit card) for journey expenses for myself and/or those traveling with me. The following details are given below.

Credit Card Authorization Form

ReservationCentre Booking Reference No. (PNR) _*

Name of Sales Person _*

Customer Name _*

Card Holder Name as on card _*

Credit / Debit Card Number _*

Card Type_*

Credit / Debit Card Expiry Date _*

CVV No _*

Authorize Amount _*

Address 1 _*

Address 2 (optional)

City _*

State _*

Country _*

Zip Code _*

Contact Details

Billing Phone _*

Billing Email Id _*

Attachment (optional)

I / We confirm that I / We have read the Terms and Conditions online and accepted all the Terms and Conditions governing our purchase of an air ticket or any other service from reservationcentre.us. In addition, I / We also confirm that I / We have verified that all information entered during the reservation process is accurate. I / We also acknowledge that this will serve as your electronic signature. (Please check the box to continue.)