Credit card letter of responsibility/authorization

I, ______________________, authorize SC ALCEDO GRUP

first and last names

SRL (Explore ),

located in Chisinau, Republic of Moldova to charge my credit card in the amount

of _______________________________________Euro (______ EUR).
in letters
in figur
es
The credit card information is as follows:
Card Type:
_________________________________________
Card Number:
_________________________________________
CVV (or BHS code):
_________________________________________
Expiration Date:
_________________________________________
Cardholder's Name:
_________________________________________
Description of Purchase: _________________________________________
(air ticket, travel package, cruise etc.)
travel dates __________________________
_____
(travel period)
Billing address:

_________________________________________

I, hereby, confirm that I am the holder of the card and that there are enough fu
nds available on my card to cover the amount I am authorising.
Signature of Card Holder __________________________
(must corre
spond to that in your passport or ID)

Date: ___________________

Please, scan this Letter and email it on info@explore.md (secured email address
with limited access).
Please, also attach a copy of your passport which contains your personal data an
d your signature.

S.C. ALCEDO GRUP S.R.L. has the obligation to respect your privacy and to safely m
anage the data that you provided us. The collected data will be used only for th
e purchase described above.