CREDIT CARD PAYMENT BY FAX
(Accepted credit cards, Visa and Master Card)
In lieu of my credit card imprint, I, _______________________________________________________ Name of cardholder (as shown on credit card) Hereby authorize ____________________________ ________________________ ____________ Credit card name Credit card number Expiration date Security code (three letter code on back of card) ___________ in the amount of _________________for payment/deposit for booking #_________
for _________________________________________________________________________________
Full name(s) of passengers if other than cardholder My Billing address is: _________________________________________________________________ Home Phone______________________Work Phone_____________________ By signing below, I hereby acknowledge charges described herein. X____________________________________ Date_______________ Signature of cardholder Please fax form to Calypso Island Tours at 1-650-624-9891 |