Credit Card Authorization Form

 
Please print this form, fill it out top and UCC form entirely, and fax it along with copies of both sides of the credit card AND the front of your valid drivers license to (972)702-8633.  I must have printed signature on file for each transaction so e-mail is not sufficient.

We can not process your reservation without all copies requested. 

 

Date:_____________________________
Passenger Name(s):______________________________________ __________________________________________________________________	Agent Name:Bob Wood
Billing Address (will be authenticated):_________________________________________	UNI-Travel Cruises & Tours
_____________________________________________________	804 Hillsdale Drive
_____________________________________________________	Richardson. TX 75081
Phone:________________________________________________	Phone:972-702-6446 - 800-359-6625
Fax:______________________________	Fax:    972-702-8633

Name as it appears on the card:______________________________________________________________ Card type: VI AX MC ETC.

_________________________________________________________________________________________

Cardholders Signature

Credit Card Number:_________________________________________________________ Exp. Date:______________ Security code:__________

If submitting this form with your corporate travel profile - the following is not required. I, _______________________________________authorize UNI-Travel Cruises & Tours to charge $____________to my credit card.

The charges are for_________________________________________________________________________________  ________________________________________________________________________________________________  ________________________________________________________________________________________________

In the event I must cancel my trip, I understand that UNI-Travel Cruises & Tours will retain the earned commission regardless of whether or not insurance is purchased.

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