Credit Card Authorization Form


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Picasso Travel will not process bookings without a customer's signed credit authorization form. 
Your order will not be processed until we receive this form. Please send it to the attention of _________________.

 Please print and fax the signed authorization form to your local Picasso Travel Office.

LOS ANGELES:
Fax:(310) 919.2985
NEW YORK:
Fax:(212) 244.0747
CHICAGO:
Fax: (847) 635.3088
SAN FRANCISCO:
Fax:(650) 579.7387
FT. LAUDERDALE:
Fax:(954) 564.7876
BOSTON:
Fax:(617) 867.0219
DETROIT:
Fax:(248) 593.1072
DALLAS:
Fax: (972) 385.7331

ALL BOOKINGS MADE THROUGH OUR WEBSITE NEED TO BE FAXED TO LA OFFICE (310) 919-2985

If you cannot print this form, please contact us at 310-645-4400 and we will fax you a copy of the authorization form.

Please print your Order ID/PNR: _______________

   
I ____________________________________
(Credit Card Holder's Name)
understand that Picasso Travel will act as the merchant on the behalf of
 

 
________________________________
(Travel Agency Name)

for my purchase of airline tickets for the amount of $__________.
I authorize Picasso Travel  to charge my  
___________________
(Type Of CreditCard)
Number __________________________
with expiration date ______/_____ Security Code (CCV):______
Card Holder's Contact:

Street : __________________________________
City : _____________________________ State : ______ ZipCode : ___________
Phone : __________________ Fax : ____________________
Name : ___________________________ Signed : _________________________
Date : _____________________________
Passenger Name: _______________________________________ Date of Birth______________
Passenger Name: _______________________________________ Date of Birth______________
Passenger Name: _______________________________________ Date of Birth______________
Passenger Name: _______________________________________ Date of Birth______________
Passenger Name: _______________________________________ Date of Birth______________

NOTE:. 3RD PARTY CREDIT CARDS WILL NOT BE ACCEPTED.
We can only accept credit cards that are issued in the
United States.