A LEGIBLE copy of the front & back of credit card and a copy of your driver's license must be faxed with form.
Debit or Credit Card
Credit Card Number
Security Code
Exp. Date (mm/yy)
Person's Name On The Card
Billing Address -- Where You Get Your Statements
Trip Date
Trip Description
Date
First and Last Name
Phones: Home
Work
Mobile/Cell
E-Mail Address
Mailing Address
Street Address
I consider this credit card authorization form to be as binding as a credit card imprint and I am using it in lieu of an imprint. I am authorizing the above charges. I agree to not dispute any charges listed on this form or cause any charge backs to the suppliers named on this form or to Stoney Creek Travel for the trip purchase or any applicable fees.
Sec. Code is 3 Digits On Card Back of MasterCard/Visa/Discover. Four Digits on front of Am. Exp.
INFORMATION ABOUT PERSON SUBMITTING FORM
Type of Card
Names of Travelers / Birth Dates
Plan Name
Auth. Fee Payment
CREDIT CARD AUTHORIZATION FORM -- Fax to 828-658-3080
If you have questions while filling out the form, don't guess -- please call me
Phone: 828-658-2582 / 877-658-2582
TYPE THE NAME OF COMPANY SUPPLYING YOUR TRIP -- SUCH AS Carnival Cruise Line, DFW Tours, Holiday Inn, Marriott, Delta Queen Steamboat Co., Delta Airlines, etc. TYPE THE DEPOSIT OR FULL COST OF TRIP In Auth. Chg. Box. Include insurance cost if you are buying from supplier & NOT buying it from Travel Guard
