Credit Card Authorization Form

Authorized Amount

Charge Card On/After

Authorization Comments

Card Holder Billing Information

Multi-line address

Country/Region

Address

City

Zip / Postal code

Credit Card Information

Important Notice: By completing this form, you are authorizing the use of your full credit card number for future payment processing on the date you selected above. Please note, this form serves solely as a payment authorization. Your card details will be stored securely and will not be transmitted via email when the form is submitted.

Name on Card

Card Type

Credit Card Number

Expiration Month

Expiration Year

Security Code

Authorization Acknowledgement

Credit Card Authorization Statement

In place of providing a physical imprint, I, (Cardholder’s Name), hereby authorize Travel With VK to use my credit card information to process payment for the reservation detailed above, in the amount specified.

By signing this form, I acknowledge and agree to the Terms & Conditions related to this transaction. I also understand that cancellations may result in penalties as determined by the travel supplier, and I agree that Travel With VK and my travel advisor are not responsible for any such charges.

First name

Last name

Trip Confirmation Number

Signature

Signature field is empty.

This is a checkbox.