TO: ASTRA
Fax: 7 499 409
5971
Tel : 7
499 409 5971
E-mail: visa@visaru.com
FROM:
Phone:
Fax:
Company:
CREDIT
CARDHOLDERS
AUTHORIZATION
I lieu of my
credit card
imprint I (name
of credit card
holder shown on
credit card),
hereby authorize
"Astra Inc." to
charge my credit
card.
AMEX
VISA
MASTERCARD
DINERS JCB
#
Valid till
/
MM/YY
In the amount of CSC
(card security
code).
The last 3
digits AFTER the
credit card
number in the
signature area
of the card
Batch
code (4
figures just
above the main
line of figures) (for
AMEX cards only)
This charge is
related to
travel services
for myself
and/or (full
name of each
passenger if
other than
cardholder)
Passenger 1
Passenger 2
Passenger 3
For the
following
services
My billing
address
Phone: Fax:
E-mail:
By signing
below, I
acknowledge
charges
described
herein. Payment
in full to be
made when billed
or in extended
in accordance
with standard
policy of card
issuer. In case
of bank
canceling
authorization,
"Astra Inc." has the
right to cancel
reserved
services.
Attention! We
don't accept
Visa Electron. While paying by credit card you pay 5% more as tax.