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| CREDIT CARD FORM. PLEASE COMPLETE PRINT THIS FORM, COMPLETE
ALL RED AREAS, SIGN IT, AND FAX IT TO (516) 248-3496. THANK YOU. Lynott Tours, Inc. 205 Mineola Blvd, Suite 1B, Mineola, New York 11501 USA Reservations Phone: (800) 221-2474 Telephone (516 ) 248-2042 Fax (516) 248-3496 DATE: _____________________Client Name: ________________________ Date of travel or Quote number: ____________________________________ email address: _________________________________________ This form is to be completed and signed by the cardholder. We do not accept an agent signing on behalf of the client. Deposit/full payment of $______________ is due no later than ___________________. Final payment is due 95 days prior to your departure. I acknowledge the cancellation fees of up to 100% will be charged to my account in the event of cancellation. Payments will be processed through LYNOTT TOURS, INC. ____ I do ___ I do not require travel insurance. Birthdates needed for all to be covered: ___ I do ____ I do not want car insurance. (Self drive programs only) TERMS AND CONDITIONS: I am a client of Lynott Tours, Inc. I hereby appoint the owner, manager, and all employees of LYNOTT TOURS, INC. to be my attorneys-in-fact for the purpose of signing charge card forms to purchase and issue travel documents, and to charge these purchases to my: PERSONAL CREDIT CARDS ONLY - NO DEBIT OR CORPORATE CARDS
I authorize the attorneys-in-fact to sign credit card authorizations for the purchase of travel documents whenever any of them receives a telephone call, reasonably believed to be from me, requesting that those tickets or documents be charged to this credit card account. I agree that I will pay for all such purchases and will hold Lynott Tours, Inc. responsible for its actions pursuant to this power of attorney. My charge is being processed through LYNOTT TOURS, INC. Date: _______________________ Signature:________________________________________ Cardholder only to sign Cardholder address: _________________________________________________________ City: ____________________________ State: ________ Zip:________________ I am enclosing a picture ID (i.e., driver's license) and certify that the signature is in fact, mine. |
