AIRPORTSPICKUP.com™

P.O. Box 612465

N Miami, FL 33261

(877)800-6500 - (212)927-7152 - (305)420-5575

+44.20.7993.2268 From Europe (London local #)

Fax (917)591-8290

 

 GENERAL CREDIT CARD AUTHORIZATION FORM FOR  NEW ACCOUNT PURPOSES

 

Card member first name:

Middle

            

 Last name:

Billing street address:

Billing city:

 Billing state Billing zip:

Contact name:

 Phone # Ext:
email:
   

Credit card details
Type:  Card # Exp

    Sec digits

 
Place a copy of front and back of credit card in the space below

PLACE COPY OF CARD FRONT HERE!!

PLACE COPY OF CARD BACK HERE!!

or scan front and back of card and send it by E-mail
 

I, the undersigned, hereby authorize Executive Transportation Inc., D/B/A AirportsPickup.com to automatically deduct payment from the credit card listed above for all charges incurred in relation with my personal account

·       A $3.00 or 3.50% (whatever is higher) credit card processing surcharge will be added to total voucher amount.

 

Card member signature: ___________________________  Date: ___________

Please complete, print, sign and fax/mail it to Executive Transportation using the information above.