Payment - Akshar Travels LLC

PAYMENT AUTHORIZATION FORM

Dear Guest,

The below form must be FULLY completed and submitted to confirm your travel plans.
Please call +1 888 881 5755 to confirm your order.

Thank you for choosing AksharTravels

Let us know your holiday planning by filling below form. Fields with * are mandatory to fill.

TO : AKSHAR TRAVELS
Your Name*
Contact No.*
This is to confirm that, in keeping with all applicable laws, we are instructing akshar Travel to issue the following tickets or confirm travel plans against the credit card, cash, check or online transfer information listed below. It is expressly understood that this amount charged does not include or constitute any additional fees related to our acceptance of credit cards / check / online transfer as a form of payment, unless permitted by law. We further represent the credit card / check / cash / online account holder stated below has authorized this transaction and that we will indemnify and hold akshar Travel harmless with respect to these instructions. It is understood and accepted that to provide additional security for our benefit, akshar Travel may on request by us, verify the credit card / check / cash / online account holder’s billing address and may, with our approval, deliver the ticket(s) directly to that billing address. It is further understood and agreed that we accept full responsibility for the amount due akshar Travel, even if the card holder rejects the credit card charge or puts stop payment on the check or online transfer for any reason whatsoever and even if we are not paid by our customer.

ACCOUNT HOLDER DETAILS
Name of Account Holder*
Billing Address of Account Holder*
Street Address City State / Province / Region ZIP / Postal Code Country
Contact No. of Account Holder*
Form of Payment*
- Credit Card
- Check
- Cash
- Online Transfer
Credit Card No.*
Credit Card Expiration Month
*
CVV*
Check or A/c No. for Online Transfer*
Issuing Bank*
Is Card / Check Holder Travelling?*
- Yes
- No

Name of Passenger(s)*

Booking Number
Travel Date*
Amount to be Charged ($)*
Please enter a value greater than or equal to 0.
Payment For*
This is to confirm that, in keeping with all applicable laws, we are instructing akshar Travel to issue the following tickets or confirm travel plans against the credit card, cash, check or online transfer information listed below. It is expressly understood that this amount charged does not include or constitute any additional fees related to our acceptance of credit cards / check / online transfer as a form of payment, unless permitted by law. We further represent the credit card / check / cash / online account holder stated below has authorized this transaction and that we will indemnify and hold akshar Travel harmless with respect to these instructions. It is understood and accepted that to provide additional security for our benefit, akshar Travel may on request by us, verify the credit card / check / cash / online account holder’s billing address and may, with our approval, deliver the ticket(s) directly to that billing address. It is further understood and agreed that we accept full responsibility for the amount due akshar Travel, even if the card holder rejects the credit card charge or puts stop payment on the check or online transfer for any reason whatsoever and even if we are not paid by our customer.

Section Break
Customer Signature*
Drop files here or

Accepted file types: jpg, gif, png, pdf, bmp, jpeg, doc, docx.
*
- I authorize to pay above amount without any dispute. For the above booking, I understand that in the event of cancellation or changes, a penalty and fees may be assessed. I hereby agree to Terms & Conditions
Your travel plans will not be finalized unless we receive this payment form. Thank you for your business.

India phone :	18002339008
India Address :	Akshar Travels Pvt. Ltd 9, City Centre, 2nd Floor, Swastik Cross Road, C. G. Road, Ahmedabad 380009. Gujarat (India)

USA Phone:	001 888 881 5755
USA Address:	Akshar Travels LLC 1183 Green Street, Iselin, NJ 08830
Atlanta Phone:	(404) 400-2744
Atlanta Address:	2615 George Busbee Parkway Suite 17, Kennesaw, GA 30144