I __________________________________________ hereby authorize VK Travels to charge my Credit Card for travel purpose.

Card No. : _______________________________________

Card Type : Master Card / Visa / American Express (Circle One)

Expiry Date: ____________3/4 digit CVS (Security Code) from back of card ________

Amount : ________________________________________

Bank of Issue : ____________________________________

Driving Licence No.: _____________________State of Issuance:__________________

Card Holder's Name : ______________________________

1-800 No from back of Card : ______________________________________

Billing Address : ________________________________________________________________________________________________________________
Mailing Address : ________________________________________________________________________________________________________________
Home Phone : ______________________________________

India Contact nos : ______________________________________

Fax : ______________________________________________
Is the Card Holder travelling ? YES   /   NO
I ________________________________(card holder) agree to pay the travel expenses for ___________________________ (name of person traveling) with my credit card , details of which are listed above.
I understand that the Refund/ Cancellation penalties that have been explained to me relating to this type of purchase will still be applicable and acceptable.
PLEASE FAX THIS COMPLETED FORM WITH CREDIT CARD FRONT AND BACK AND A COPY OF PICTURE ID TO 1-510-770-1934.

Signature of Card Holder : __________________________________
Date : __________________________________