Credit Card Authorization Form

I, ________________________________, hereby authorize, Akbar Online Booking

Co. Pvt. Ltd. to charge my credit card for an amount not to exceed Rs.
_________________
Card Type (pls tick)
( ) VISA
( ) MASTER
( ) AMEX
Credit Card Number __________________________
Expiration Date: _____________________________
Bank Name _________________________________
Credit Card Billing Address:
Street ______________________________________
City _______________________________________
Pin Code: __________________________________
Telephone Number: (Prefix ISD & STD Codes) ____________________
Mobile Number: _________________________________________
Card Holders Signature ____________________________
Date: ___/ __/____