FROM ANSO TRAVEL SERVICES
IN ORDER TO MAKE YOUR PAYMENT FOR THE (TO BE) PROVIDED SERVICES FROM OUR COMPANY EASIER,
WE OFFER YOU THE POSSIBILITY TO PAY BY CREDIT CARD.
TO GIVE ANSO TRAVEL SERVICES THE LEGITIMATE RIGHT TO TRANSFER YOUR PAYMENT TO OUR BANK ACCOUNT,
WE KINDLY ASK YOU TO :
PRINT THIS AUTHORIZATION FORM,
FILL IN THE FOLLOWING PERSONAL DETAILS AND THEN
FAX THE DATA TO OUR OFFICE. (FAX NO.: 0030 28320 31713)
| NAME: | .................................................................................................................................................. |
| ADDRESS: | .................................................................................................................................................. |
| POST CODE: | .................................................................................................................................................. |
| COUNTRY: | .................................................................................................................................................. |
| TELEPHONE: | .................................................................................................................................................. |
| FAX: | .................................................................................................................................................. |
| E-MAIL: | .................................................................................................................................................. |
| MOBILE: | .................................................................................................................................................. |
| TYPE OF CREDIT CARD: | |
| VISA | WITH NUMBER: ...................................................................................... |
| MASTER CARD | WITH NUMBER: ...................................................................................... |
| EURO CARD | WITH NUMBER: ...................................................................................... |
ANY OTHER CREDIT CARD TYPE: ........................................... ........................................... |
WITH NUMBER: ...................................................................................... |
VALID UNTIL: .................................. |
|
THE UNDERSIGNED DECLARES HEREWITH THAT ANSO TRAVEL SERVICES, REPRESENTED BY ADONIS PAPADAKIS,
MANAGING DIRECTOR OF ANSO TRAVEL SERVICES, HAS MY PERMISSION TO TRANSFER EURO ......................................
(AMOUNT) FROM MY CREDIT CARD ACCOUNT TO HIS ACCOUNT.
| DATE: | .................................. |
| PLACE: | .................................. |
| SIGNED: | .................................. |
