CREDIT CARD AUTHORIZATION


I, hereby authorize VERMILLION INTERNATIONAL
to debit my Credit Card for the Confirmed Holiday Package & Services.
 

Fax-in Payment

Transaction Date :


Personal Particulars

Name : (Mr/Mrs/Ms)

:.....................................................................................................

Telephone : (Home/ Work/ Mobile)
Include Country & Area Code

:.....................................................................................................

Email :

:.....................................................................................................

Payment Particulars

Credit Card Type

Visa Master Amex Diners Club

Credit Card Number

secure number
(The last 3 to 4 digit number on the signature panel)

:.....................................................................................................

Card Holder's name
(same as on the Credit Card)

:.....................................................................................................

Expiry Date (MM/YYYY)

:.....................................................................................................

Card Holderís Passport No

:.....................................................................................................

Billing Address of Card Holder

.....................................................................................................
Card Issuing Bank & Tel No .....................................................................................................
Total Amount in United State Dollars / Euro

: USD / EURO............................( in figures )

Above amount in Words :.....................................................................................................

Card Holder's Signature
(same as on the Credit Card)

:.....................................................................................................


Booking Particulars

BOOKING ID :........................................................ (exp. VT2010, VT3100)
Resort/Hotel Name
Check-In Date
(day/month/year)
Check-Out Date
(day/month/year)
 
 
   

 All Travellerís / Guest Names :

I understand that Vermillion International will appear on my credit card statement for this transaction and should I have any problem with this order, I can contact Vermillion for a prompt resolution by emailing info@vermillionmaldives.com or calling +960 333 4630. The above Signature confirms that the Card Holder fully agrees the rates & services confirmed and understands that the above amount is not refundable.

Please Print this form, fill out and fax it along with Passport copy (pic/info page) of Card holder & Credit Card copy (both sides ) to our Fax number: +960 333 4631 or by scanned e-mail to accounts@vermillionmaldives.com

* For security reasons we shall verify card details and signature on arrival.

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