Universal Tours, Inc.
1237 S Jackson St. Ste A., Seattle, Washington 98144

Credit Card Authorization Form

The cardholder must complete this form and either fax or mail, along with a copy of his/her identification and the back and front of the credit card to the above address or fax to 206-623-4928.

I authorize UNIVERSAL TOURS to charge my  (CIRCLE ONE)

                         

Credit Card Number: ________________________________________________________________

Expiration Date: ____________/_____________
                                
(Month)                      (Year) 

In the amount of $ ____________________ for the purpose of: _______________________________

Name on Card: ___________________________________________________    Sex: Male / Female 

Credit Card Billing Address: ________________________________________________ Apt#_______ 

City: _____________________________________ State: _____________________ Zip___________

Home Phone: (_____)______________________ Work Phone: (_____)_________________________

 (FOR SECURITY PURPOSES DOCUMENTS WILL BE MAILED TO BILLING ADDRESS OF CLIENT) 

Email: _________________________________________________________________ (optional) 

Passenger Names should be exactly as in passport for international flights or government ID for domestic. 

Passenger 1: _________________________________________________ DOB: ________________ 

Passenger 2: _________________________________________________ DOB: ________________ 

Passenger 3: _________________________________________________ DOB: ________________ 

Passenger 4: _________________________________________________ DOB: ________________

This authorization form is in lieu of an imprinted credit card form. I have read Universal Tours terms and conditions and give permission for the above documented amount to be charged. By signing this authorization form I shall under no condition decline, reject, or challenge the amount that has been authorized above.


Signature of Card Holder: _____________________________________________ Date: ___________ 

Thank You!   We at Universal Tours appreciate your business!


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