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
E-mail address: _______________________________________________
I authorize Ekstra Tourism & Travel, A.Þ. to withdraw the amount appearing below.
it appears on the card:
|month / day / year
Please print name and
surname as it appears on the card: _____________________________________
|Credit card type (please circle one):
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