Credit Card Authorization Form

Dear Valued Customer,

In order to secure your reservation, this credit card authorization form must be filled. Thank you for interest and we appreciate your business. Have a great day ahead.

Respectfully,
Atlanta Limousine Service

    Amount:

    Type of Card:

    Card Number:

    V-CODE (Visa / Mastercard):

    The last three digit numbers on white strip behind card.

    V-CODE (AMEX):

    Four digit numbers on front of card above the card number.

    V-Code:

    Expiration Date (MM/YY):

    Billing Address:

    Billing City:

    Billing ZIP:

    I hereby authorize Atlanta Limousine Service to charge the above amount to the credit card account described above according to the card issuer's agreement.

    Date (MM/DD/YY):

    Card Holder Name:

    Names of Passengers (Separated by Comma):

    Reservation Confirmation Number: