Back up Only * Back up Only * Back up Only * Back up Only * 

This form must be FULLY completed before tickets can be issued.

TO: Alanita Travel 87 Common Street, Watertown, MA 02472  Ph: (617)923-4810 Fax : (617)701-1750

 

I, (Credit Cardholders name) request Alanita Travel to issue the tickets below and authorize Alanita Travel to charge my credit card for the amount listed below in the event that my other form of payment is not received within 5 business days of the date on this form. I am aware that Alanita Travel will take an “authorization” on my credit card for the amount on this form, but the card will only be charged in the event that I do not make some other form of payment within 5 days of the date on this form. This “authorization” on the credit card will be active for a period of 15 business days. I am aware that the cancellation fees are from $375 to non-refundable and date changes are from $275 and up.  I am also aware that the airline that I am purchasing may not accept credit cards so it may not be possible for me to receive any additional benefits or insurance offered by my credit card company.

Alanita Travel is not responsible for seat assignment, Frequent Flyer numbers, meal preference or VISA REQUIREMENTS of any kind

**Please check your itinerary for name spellings. We do not use this page for spelling corrections***

Names of Passengers:(Last Name / First Name)

1.

2.

3.

4.

 

Airline :  

Cardholder Name(s)

Email Address

Cardholder Phone (W)

(Home)

 

Passenger's Phone # in India:

Passenger's Email:

 

Credit Card Type

(No Debit Cards or Corporate cards)

 

 

Credit Card Number

Expiry Dt

 

 

Total amount to be charged $ (4.5% CC fee will be added to this amount)Add $12 if you need courier service. Not applicable for E-tickets

 

 

Billing Address 

Add.  

City  State  ZipCode 

 

Issuing Bank :

Bank Customer Service phone # :

 Please fax a copy of your credit card Front and Back *Lighten Copy Please*

Yours truly,

Signature here: X___________________         Date:_______________