CARDHOLDER INFORMATION

Full Name: ____________________________________________

Billing Address: ________________________________________

______________________________________________________________

City: ______________________ State: ______________________

ZIP Code: ______________________

Phone Number: ________________________________________

Email Address: ________________________________________

TRAVELER INFORMATION

Passenger / Traveler Name(s):

______________________________________________________________

______________________________________________________________

______________________________________________________________

PAYMENT INFORMATION

Card Type: ☐ Visa ☐ Mastercard ☐ American Express ☐ Discover

Name on Card: ________________________________________

Last 4 Digits of Card: ________________________________

Expiration Date: ______________________________________

Authorization Amount: $ ________________________________

Invoice / Booking Reference: __________________________

AUTHORIZATION

I hereby authorize Sardar Patel Travel LLC to charge the above referenced credit card for approved travel services, supplier charges, service fees, and related travel expenses.

I confirm that I am an authorized user of this credit card and that all information provided is accurate and complete.

I understand and agree that:

• Travel bookings may be non-refundable and subject to supplier rules.
• Refunds and cancellations are governed by airline, hotel, cruise line, and supplier policies.
• Sardar Patel Travel LLC acts as an intermediary between travelers and third-party suppliers.
• Chargebacks submitted without first contacting Sardar Patel Travel LLC for resolution may be disputed using this authorization and booking documentation.
• Additional identity verification may be requested for fraud prevention purposes.

CARDHOLDER VERIFICATION

For security purposes, please provide:

• Copy of government-issued photo ID
• Copy of front of credit card (last 4 digits visible only)

For your protection, please black out the middle card numbers and CVV code before submitting.

SIGNATURE

Cardholder Signature:

______________________________________________________________

Date: ________________________________________________

This authorization form is governed under the laws of the State of Texas, United States.

• Government-issued photo ID
• Copy of payment card showing only last 4 digits
• Signed authorization form
• Booking confirmation details