We will only accept on-line payment (through PayPal) for the time being.  This Credit Card Authorization (CCA) form has been obsolete.


Tel: (86-10) 8580-1244      Fax: (86-10) 8580-1249                           www.orientaltravel.com

Please fax us your credit card authorization to guarantee your limousine reservation. Our fax number is: (86-10) 8580-1249

I, _______________________________________ authorize King Promise Consulting Ltd to debit my credit card account total amount:

US$____________________ (CNY(RMB)                              ) to be the payment for my limousine service charges.

My limousine reservation details is as following:

Date required: ___________(DD/MM/YY)  Flight Number____________

My flight arrival/departure time:____________________(A.M./P.M.)

Pick-up from (airport/hotel):__________________________________

Transfer to (hotel/airport):____________________________________

Note: We accept Visa ___, Master ___or AE Card ___ only.       

I agree King Promise Consulting Ltd to charge my credit card for the full amount of the Limousine Service Charges if I do not show up for the limousine service as reserved.                                

Credit Card Number:______________________________  

ˇ@

Passport Number:______________________________________

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Expiry Date: ______________. (mm/yy)   Three Digit Code: ___________(For Visa and Master Card, last 3 digit number on the back of credit card)

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Card Holderˇ¦s Name: _________________________________________. (Must be the same as appear on your credit card and same as the person using the service)

Credit Card Issuing Bank: ____________________________________

Credit Card Issuing Country: _____________________

Credit Card Billing Address: _______________________________________

_______________________________________________________________.  (The mailing address to receive your credit card statements)

My Email Add: _______________                                                               

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Tel ________________                     Fax:_______________

 

Card Holder's Signature: ____________________________Date:__________

 

Note:

Upon successful completion of this payment transaction, the merchant name in your credit card statement will be shown as "HUANXUN DIANZI SHANGWU    SHANGHAI" being the Chinese name translation of our third-party online payment solution provider - International Payment Solution (IPS) Shanghai - which has been entrusted to accomplish our CCA online payment function.