AUTHORIZATION TO CHARGE ON CREDIT CARD
FOR TOUR ORDER
Please fill in all the fields, Print the Page, and Fax it to 516-693-9125
American Express
Visa
Master Card
  Card Holder Name:  
  Card Number:  
  Card Expiration Date:  
  Total Amount (US):  
  Passenger Names:  
 
 
  My billing address is:  
  Home Number:  
  Office/Cell Number:  
  Fax Number:  
       
       
 

In lieu of my credit card imprint, I ____________________________________________ , hereby authorize Skyline Travel, Inc./toindia.com and/or their representative to charge my Credit Card for the amount shown above. I understand this is a final non-disputable transaction. By signing below,
I acknowledge the charges described above. Payment in full to be made when billed or in accordance with the policy of the company issuing the credit card.

 
 
  Card Holder Signature:  ____________________________________
 

NB: Please do include front and back copies of the credit holder's driver's license and the credit card along with this authorization.