If you want to download Credit Card Authorization Form as a Word file,
    Please click here.

    Credit Card Authorization Form

    This form must be printed, completed and faxed to Ekstra Tourism each time a credit card payment is to be made. For your convenience, this page can be printed from our website.

    Company name (if any):_______________________________
    Address of card holder:_______________________________

    Please include country & regional codes:

    ___________________ ___________________ ___________________
    home phone number work phone number fax number

    E-mail address: _______________________________________________

    I authorize Ekstra Tourism & Travel, A.. to withdraw the amount appearing below.

    Authorization signatureas
    it appears on the card:
    ___________________ Date:__/__/__
    month / day / year

    Please print name and
    surname as it appears on the card: _____________________________________

    Credit card type (please circle one): VisaMasterCard

    Card number: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

    Card security number / PIN: ________ Card expiration date: __ __ __ __ __ __

    Total Amount in US dollars: ________________

    NOTE: Notification of the credit card transaction will be made within one business day either by email or fax. After the tour(s), Ekstra Tourism will mail an invoice of all payments addressed to the company name. If there is no company name, then the invoice will be addressed to person who authorized the payment.

    Please fax this form to Ekstra Tourism: (90) 216-565 6728