I, the undersigned (Print Name)    authorize India Travel Plan/Consolidator and Airline to charge my credit card representing payment for 
booking reference -      for the following passengers : 
: 
: 
To charge the amount:    To my:Visa      Mastercard    AMEX 
                                 
Credit Card Number :   Security Code:    Expiration Date:

Print Name   Signature_________________________________  Date:

E-mail:  

Billing Address:

City:    State   Zip:

Billing Phone:

I/We are aware of any cancellation policies and agree not to dispute or attempt of Chargeback any of the above signed for and acknowledged charges.
Cardholder Initial ________