Executive Transportation
d/b/a AirportsPickup.com
P.O. Box 612465
Miami, FL 33261

(877) 800-6500 ~ (718) 374-5066
+44.20.7993.2268 | Fax (917) 591-8290



Credit Card Authorization Form

Note: Please complete online, print, sign and either fax or scan & eMail.
 
Card holder's first name: Middle name: Last name:
Billing street address:    
Billing city: Billing State: Billing zip:
Contact name: Phone #: Extension:
eMail:      

Credit Card Details

Card type: Card #: Exp date: Sec Code (CVV):
 
  Choose CC authorization type  

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, take picture of front and back of card and send it via eMail to:

 
I, the undersigned, hereby authorize Executive Transportation Inc., D/B/A AirportsPickup.com to automatically
deduct payment from the credit card listed above to cover all charges incurred in relation with my reservation(s) # in behalf of (passenger's name).
 
Card member signature: __________________________________________  Date: _______________