Beau Monde Service & Travel Agency

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Home Terms & Conditions

Beau Monde Service Credit card letter of responsibility or authorization

Credit card letter of responsibility / authorization
 

I, , authorize Dollar Thrifty Armenia "Beau Monde Service" LLC., to authorize my credit card in the amount of USD (in drams according to the exchange rate).

The credit card information is as follows:
Card type:
Card number:
3 digit security code
at the back of the card
Expiration date:
Name of card holder:
Name of Renter:
Type of service:
Billing address of card holder:
Address for air delivery
(no p.o.box)

Signature of card holder: _____________________________date: _________

 Please attach:

1. Copy of driver’s license:

2.Credit card copy:
Front: back:
Sign the copy


Fax to: 00374(10) 599 965
I agree that my liability for this bill is not waived, and i agree to be held personally liable in the event that the indicated person, company or other association fails to pay for any part of the full amount of these charges.

 

Printsignature:_______________________