FDF
IATA_Universal_Credit_Card_Authorization_Form.pdf
CREDIT CARD CHARGE FORM
Keep a copy of this document for your records
Agency Name:
Imprint credit card here
Ticket Number:
Airline Code:
Passenger Name:
Payment Details
1- Visa
2- MasterCard
3- American Express
4- Diners
5- Discover
Credit Card Number:
Expiry Date (MMYY):
Authorized Amount USD:
CVV Code:
I acknowledge receipt of ticket(s) and/or purchase of transportation related services and/or goods for the charges
described hereon. I am aware of applicable restrictions and/or penalties associated with this purchase.
IATA Code:
Cardholder Name:
Click here to Upload File
Signature
Date (MMDDYYYY):