I, the credit card holder hereby authorize TravelsMaker to charge my credit card or designated supplier by TravelsMaker to charge my Credit Card as per particulars below. I fully understand and agree on the itinerary and restrictions on the ticket(s) already Explained or E-mailed to me by TravelsMaker.

I am also fully responsible for any Charge back dispute and  Non-payment to Credit card Company or Issuing Bank.
Please verify all the names and dates and fill out this form

Name *
Itinerary Received: * YesNo
Total Amount to be Charged (in $) *
Company Name:
Credit Card Holder's Name: *
Card Holder Billing Address: *
Country: *
Zip: *
Card Holder's Phone : *
Credit Card Type : *
Credit Card Issuing Bank / Company: *
E-mail Address : *
I have verified the complete itinerary as per my request.
Card Holder's Signature : *
Passenger's Details

Name as on passport Gender

Comments / notes: