Cyprus-villas.com
Contact fax 00357 24 627489
Fax Authorisation for Visa or MasterCard
Name of Cardholder......................................................................................
Billing Address ................................................................................................................
..................................................................................................................
Contact telephone number
......................................................................................................
Country....................................................................
Card
Number............................................................................................
Expiry Date......................................Last 3 digits on back
..................................................
Amount Authorised
…C£....................................
Now in words
please…C£.......................................................................................................
Details of
accommodation..............................................................................
Number of pax : .........Adults...............
Children...................... Infants..........................
Date/Time of arrival……………………… Flight no......................
Airport............................
Date/Time of departure…….……………Flight no.......................
Airport............................
Transfers Yes........... No ............
Car Hire Yes........... No
.............
I hereby authorize you to debit my account for the amounts stated above.
Signature of cardholder
.......................................................................................................Today's
Date..............................
Print and Fax this form to
+357 24 627489 - Thank you.
