Air-Savings.com

860 US Highway 1, Second Floor, Suite 7, Edison, NJ 08817
Phone: (732) 287-9100   Fax: (732) 362-7908

Credit card Authorization

In Lieu of my credit card imprint, I                                                                                      authorize
Air-savings.com to charge my following credit card,

Amex / Visa / Master / Discover
(circle the appropriate card type)
Credit Card Number:                                                                  Expiry Date (MM/YY)          /          
CCV code                                 (Amex - 4 digits / others - 3 digits).

Card Issuing Bank Name                                                     Phone Number          -           -              
for a total charge amount of $                                                      for the following itinerary,
 
 
 

Phone: Home:             -              -                    Work:             -               -                    Ext:          
E-mail id:                                                     
Billing Address:
 
 

By signing below I acknowledge charges described hereon.
Payment in full to be made when billed in accordance with the issuing bank.
 I have read the terms and conditions of Air-savings.com online, and agree to them.
 

Cardholder's Signature X                                                       X            Date:          /       /           

Incomplete/false statements shall be considered sufficient cause for denial of ticket/s.