Credit Card Information Please print this form and sign below. Signed form must be faxed to (868) 623-3341 to process payments.
Date:
To:
Travel Network Inc. Ltd.,
9 Colville Street, Woodbrook, Port of Spain.
Fax: (868) 623-3341
This is your authorization to debit my credit card for fare charges related to:
Passenger's First Name:
Passenger's Last Name:
Amount to be debited:
TT$
My billing details are:
Credit Card:
Cardholder's Name:
Card Number:
Expiration Date:
Cardholder's Address:
Cardholder's Tel. No.: (home)
Cardholder's Tel. No.: (business)
PAYMENT IN FULL TO BE MADE WHEN BILLED OR IN EXTENDED PAYMENTS IN ACCORDANCE WITH STANDARD POLICY OF COMPANY ISSUING CARD AS REFLECTED IN APPLICABLE TARIFFS. ACCEPTANCE SUBJECT TO VERIFICATION.
