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Credit Card Charge Authorization Form
Hidden Trails Credit Card Charge Authorization Form
In order to accept your payment with your VISA or MasterCard, we require you to fill out the following form and send it via fax to our office (+1-604-323-1148).
Information enclosed is confidential.
VISA/MasterCard Credit Card Data:
Full Name
(as it appears on credit card) |
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| Bank |
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| Credit Card Number |
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| Expiration Date |
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| 3-digit Security Code |
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| Address that credit card statement gets send to: |
| Address |
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| City, State Zip |
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| Country |
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| Trip Reference |
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| Tour Name |
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| Departure Date |
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| Names of clients traveling |
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| I hereby accept to be charged through my VISA/MasterCard the full amount of: |
| USD$ |
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| Your signature |
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| Date |
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