Credit Card Authorization & Booking Form
Credit Card Authorization & Booking Form
This form must be completed and signed by the Lead Traveler before any payment is processed. It serves as your formal authorization for Luxury Travel TrustinUs to charge the payment method provided for the travel services outlined below.
1. Lead Traveler Details
Full Name (as on passport): ___________________________
Date of Birth: ___________________________
Passport Number: ___________________________
Passport Expiry Date: ___________________________
Email Address: ___________________________
Phone Number: ___________________________
2. Booking Summary
Destination(s): ___________________________
Departure Date: ___________________________
Return Date: ___________________________
Number of Travelers: ___________________________
Booking Reference: ___________________________
3. Itemized Cost Breakdown
| Service | Provider | Amount (GBP) |
|---|---|---|
| Flights | ___________ | £___________ |
| Accommodation | ___________ | £___________ |
| Transfers | ___________ | £___________ |
| Tours / Excursions | ___________ | £___________ |
| Agency Service Fee | Luxury Travel TrustinUs | £___________ |
| Total Amount | £___________ |
4. Payment Authorization
I, the undersigned, hereby authorize Luxury Travel TrustinUs to charge the following payment method for the total amount stated above:
Cardholder Name: ___________________________
Card Type (Visa / Mastercard / Amex): ___________________________
Last 4 Digits of Card: ___________________________
Billing Address: ___________________________
5. Traveler Names (Passport Names)
Please list all travelers exactly as they appear on their passports:
- ___________________________
- ___________________________
- ___________________________
- ___________________________
6. Declaration & Acknowledgment
By signing below, I confirm that:
- I am the authorized cardholder and consent to the charge(s) described above.
- I have read, understood, and accepted the Client Booking Terms & Conditions of Luxury Travel TrustinUs.
- I understand that deposits are non-refundable and cancellation charges may apply.
- All traveler names provided match their valid passports exactly.
- I accept responsibility for ensuring all travelers have valid travel documents and appropriate travel insurance.
Signature: ___________________________ Date: ___________________________
Please return this completed and signed form to: bookings@luxurytraveltrustinusj.store
This document is for record-keeping and chargeback protection purposes. Luxury Travel TrustinUs is registered in England and Wales.