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2024 PYMT On EXIST Reservation (New Credit Card)
LS Travel Agency Payment Authorization Terms & Coinditions:
As Primary Traveler On Reservation and on behalf of all guests on reservation: I understand this is a disclosure of business practices and permissive credit/debit card payment agreement for the purchase of travel services. I agree that payments may be made direct to selected travel suppliers on my behalf by LS Travel Agency; paid in prorated amounts not to exceed the sum total of approved charges. I understand Debit Cards often impose “Daily Charge Limits” and multiple payments may be needed to complete the full balance due; for which you will be notified if the situation occurs.
FEES: I am aware there are potential Cancellation, Refund and Surcharge Policies and Fees by suppliers; I understand it is my responsibility to read and abide by the policies, terms and conditions as posted on supplier documents and agree not to dispute or chargeback any of the above signed for and acknowledge charges without proper course of action.
LS Travel Agency will not release personal information to ANY parties not listed below, unless provided in writing as an Emergency Contact and will apply due diligence in maintaining records in a secured, safe location.
Making A Payment On My Existing Reservation: You, authorize Lisa Streater of LS Travel Agency to make a payment on your existing reservation using a New Credit Card other than the credit card used for deposit and/or payments previously.
Booking Location:
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Travel Date:
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MM
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Credit Card Holder Required Information:
Name:
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First
Last
(Exactly as it appears on credit card)
Middle Name:
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As it appears on CC. Type N/A if it doesn't apply
Credit Card Type:
Please select
AMEX
MASTERCARD
VISA
Credit Card
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Card Number
Expiration
MM
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YY
CVV
What is this?
3 or 4 digit number printed on the back/front of your credit card
Protected in vault
Data collected via fields that have our security seal are encrypted and stored with the highest global security standard — PCI compliance. Your data is absolutely safe in Vault.
Address
Street Address
Address Line 2
City
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Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
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Denmark
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Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
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Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
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San Marino
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Spain
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Ukraine
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Russia
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Singapore
Sri Lanka
Syria
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Thailand
Turkey
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Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
As it appears on credit card statement
CREDIT CARD HOLDER TOTAL AMOUNT AUTHORIZED:
Credit Card Holder Total Amount you are authorizing for ALL traveler(s) listed above.
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$
Dollars
.
Cents
Payment Type:
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Payment on Existing Reservation
Payment In Full
Client other request(s)?
Please be as detailed as possible.
APPROVAL OF CHARGES:
As named Cardholder, I authorize Lisa Streater at LS Travel Agency to immediately charge my credit card the above amount including any additional payments required, as needed to complete the reserved Travel Package account for the primary travelers listed above.
FUTURE PAYMENT AUTHORIZATION:
I will authorize by Email, all future payments due towards Total Package cost, to be charged to the above credit card with the same terms as disclosed. I may opt to use a different credit card simply by submitting a new authorization form.
Signature
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Clear
Use your "mouse" to sign your name.
Print Name:
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First
Last
Today's Date:
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MM
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Phone
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Email:
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For receipt confirmation and any other documents reference your trip.
Lisa Streater ~ LS Travel Agency
Email: lstravels@yahoo.com