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    Authorization For Credit Card Use.1

    Uploaded by

    rene paul
    This document is an authorization form for Leloucy Raphael Andre to charge $2,460.3 USD to their Visa credit card ending in 1777 and expiring in June 2023 for a purchase from Travel-Rite Tours and Travel, LLC. It provides the cardholder's name, billing address, credit card details, amount to charge, and requires the cardholder's signature and date to authorize the charge in accordance with the issuing bank's agreement. The completed form is to be returned to Sylvia Grandberry at Travel-Rite Tours and Travel, LLC via email.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Authorization For Credit Card Use.1

    Uploaded by

    rene paul
    538 views1 page
    This document is an authorization form for Leloucy Raphael Andre to charge $2,460.3 USD to their Visa credit card ending in 1777 and expiring in June 2023 for a purchase from Travel-Rite Tours and Travel, LLC. It provides the cardholder's name, billing address, credit card details, amount to charge, and requires the cardholder's signature and date to authorize the charge in accordance with the issuing bank's agreement. The completed form is to be returned to Sylvia Grandberry at Travel-Rite Tours and Travel, LLC via email.

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    AUTHORIZATION FOR CREDIT CARD USE.1

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    This document is an authorization form for Leloucy Raphael Andre to charge $2,460.3 USD to their Visa credit card ending in 1777 and expiring in June 2023 for a purchase from Travel-Rite Tours and Travel, LLC. It provides the cardholder's name, billing address, credit card details, amount to charge, and requires the cardholder's signature and date to authorize the charge in accordance with the issuing bank's agreement. The completed form is to be returned to Sylvia Grandberry at Travel-Rite Tours and Travel, LLC via email.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    538 views1 page

    Authorization For Credit Card Use.1

    Uploaded by

    rene paul
    This document is an authorization form for Leloucy Raphael Andre to charge $2,460.3 USD to their Visa credit card ending in 1777 and expiring in June 2023 for a purchase from Travel-Rite Tours and Travel, LLC. It provides the cardholder's name, billing address, credit card details, amount to charge, and requires the cardholder's signature and date to authorize the charge in accordance with the issuing bank's agreement. The completed form is to be returned to Sylvia Grandberry at Travel-Rite Tours and Travel, LLC via email.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 1

    AUTHORIZATION FOR CREDIT CARD USE

    Print and complete this authorization and return.


    (All information will remain confidential)

    Name on Card: LELOUCY RAPHAEL ANDRE

    Billing Address: 22 RUE JEAN JACQUES ROUSSEAU 78520 LIMAY

    Credit Card Type: Visa X Mastercard Discover Amex

    Credit Card Number: 5325 0900 3621 1777

    Expiration Date: 06/2023

    Card Identification Number: 137 (last 3 digits on the back of the credit card)

    Amount to Charge: $ 2,460,3 (USD)

    I authorize Travel-Rite Tours and Travel, LLC to charge the amount listed above to the credit
    card provided herein. I agree to pay for this purchase in accordance with the issuing bank
    cardholder agreement.

    Cardholder – Please Sign and Date

    Signature:

    Date: 14 / 09 / 2021

    Print Name: LELOUCY RAPHAEL ANDRE

    Return the completed and signed form to the following:


    Travel-Rite Tours and Travel, LLC with Luxevo Vacations
    Sylvia Grandberry
    [email protected]

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