|
Confirmation Number |
............................................................ |
|
In lieu
of my credit card imprint, I (card holder) |
............................................................ |
|
Hereby
authorize WTC to charge my (credit card name) |
............................................................ |
|
Credit
card number
(Black out the middle 8 numbers) |
............................................................ |
|
-
(expiration date) |
............................................................ |
|
-
(credit card 800 number) |
............................................................ |
|
In the
amount of $ |
............................................................ |
|
For that
payment of transportation of myself and/or
(name of passenger(s))
if other than card
holder |
............................................................
......................................... |
|
For my
itinerary as follows: (trip routing) |
............................................................ |
|
Billing
address of the credit card |
............................................................ |
|
Phone
|
(h) .........................(w)
......................... |
