Credit Card Authorization

Private & Confidential

Payment Guarantee - Credit Card Authorization Form

After completion of this form please scan and email it to: service@chinatravelrus.com or fax it to 86 - 29 - 88402078  (Chinatravelrus.com only accepts Visa and MasterCard)
 To:   EASY TRAVEL CO. LTD XIAN, CHINA (Chinatravelrus.com)
          No. 166 You Yi Xi Lu, Jiamei Mansion 15th Floor 15N, Xian, 710068, China
  
From: ___________________________________________ (Name)
              ___________________________________________ (Street)
              ___________________________________________ (City, State, Zip, Country)

Chinatravelrus.com will confirm your bookings after we receive this signed & completed payment guarantee form. The deposit which is equal to 10% of the total tour cost will be drawn after your bookings are confirmed. Final payment will be drawn 30 days before departure for your China tour. (Chinatravelrus.com only accept Visa and MasterCard)
 
To the Bank of China:
I hereby authorize EASY TRAVEL CO. LTD XIAN, CHINA (Chinatravelrus.com) to charge the amount of RMB (CNY) (Which equals US$ on the date of invoice)__________________ to my Credit Card as my Tour to China.

Credit Card Type: __________________(We are unable to accept payment via Debit Card)

Card Holder’s Name: __________________________

Card Holder’s Birth Date (MM/DD/YYYY): ____/____/_____Nationality: ________________

Credit Card Number: ___________________________________________

CVV2 Number_____*(3-digits at the end of your cc number in the signature line on the back of your card)

Expiration Date (MM/YYYY): ____/_______

Issuing Bank of your credit card: ___________________________________

Billing address: (If different from above)
_____________________________________ (Name)

_____________________________________ (Street)

 ______________________________________ (City, State, Zip)

My phone number: ______________________________

My passport number ______________


Sign Here: _________________________________ (signature of card holder)

Date: _____________


Notes:
A.  The Bank of Communications / Bank of China requires a legible photocopy of both sides of your credit card. Please, send the copy (page 2) with this form.
B. To enable us to finalize your reservation you are kindly requested to fax this
completed form to us within 3 working days (or scan and email)
C. The receipt of your fax indicates that you have read and accept the Terms and Conditions as found at:

 
 
Front of Credit Card                           
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Back of Credit Card
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Card Holder Picture I.D                                                     
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