Credit Card Form

CREDIT CARD FORM. PLEASE COMPLETE PRINT THIS FORM, COMPLETE ALL RED AREAS, SIGN IT, AND FAX IT TO (516) 248-3496.or scan it to your reservationist's email address. THANK YOU. YOU CANNOT COMPLETE THIS FORM ON LINE. YOU MUST PRINT IT OUT AND FAX/MAIL/SCAN IT IN.
Australian Travel Master (div. of Lynott Tours Inc)
205 Mineola Blvd, Suite 1B, Mineola, New York 11501 USA
Reservations Phone: (800) 221-2474 Telephone (516 ) 248-2042; Fax (516) 248-3496

DATE: _____________________Client Name: ________________________

Date of travel or Quote number: ____________________________________

email address: _________________________________________

This form is to be completed and signed by the cardholder. We do not accept an agent signing on behalf of the client. Deposit/full payment of $______________ is due no later than ___________________. Final payment is due 95 days prior to your departure.Payments will be processed through LYNOTT TOURS, INC. or the airline/supplier.

___ I do ____ I do not want car insurance. (Self drive programs only)

___ I do ____ I do not want travel insurance.
TERMS AND CONDITIONS: I am a client of Lynott Tours, Inc. I hereby appoint the owner, manager, and all employees of LYNOTT TOURS, INC. to be my attorneys-in-fact for the purpose of signing charge card forms to purchase and issue travel documents, and to charge these purchases to my:
PERSONAL CREDIT CARDS or DEBIT ONLY - NO CORPORATE CARDS
  Credit Card Number   Expires CSC (on back strip
or on front of card)
Visa      
Mastercard      
American Express      
Discover (not for airfare)       
THE NAME ON THE CARD MUST MATCH THE NAME ON THE RESERVATION. (We have a different form if the signer is not the traveler.)

I authorize the attorneys-in-fact to sign credit card authorizations for the purchase of travel documents whenever any of them receives a telephone call, reasonably believed to be from me, requesting that those tickets or documents be charged to this credit card account. My charge is being processed through LYNOTT TOURS, INC. The travel products and services being purchased may be subject to additional surcharges, cost increases, and fees imposed by individual travel suppliers or government entities after the purchase date. I understand that I may be charged these post-purchase amounts for reasons varying from currency exchange fluctuations to fuel surcharges and new travel taxes. I consent to these postpurchase price increases, and I authorize Lynott Tours, Inc. to charge my credit card for these amounts.
I agree that I will pay for all such purchases and will hold Lynott Tours, Inc. responsible for its actions pursuant to this power of attorney. Iacknowledge the cancellation fees of up to 100% will be charged to my account in the event of cancellation.
Date: _______________________ Signature:________________________________________
Cardholder only to sign
Cardholder address:
_________________________________________________________
City: ____________________________ State: ________ Zip:________________
I am enclosing a picture ID (i.e., driver's license verifying address) and certify that the signature is in fact, mine.
IF WE ARE BOOKING YOUR AIRFARE OR A TOUR WE ALSO NEED:
Exact names on passport: _______________________________________________________________________
Date of Birth _______________________________ Where______________________________________
Passport # ____________________________ Date of Issue ___________________ Expiry: __________________

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