US LION TRAVEL
529 E. Valley Blvd. #208-A, San Gabriel, CA 91776 (太陽城)
(626)569-9238 (626)569-9234



CREDIT CARD AUTHORIZATION FORM



I,          , holder of credit card number                , with
expiration date on              , address                 
                                      , phone
number           , and of the driver license number              
with expiration date on         , authorize                (Name
of the travel agency) to charge my credit card mentioned above, the amount
USD$             for        . (Name of the passengers) to travel     
                                           
                  (Itinerary) departing on               .

 
Signature                 Date            
Hereby authorize my travel agent to verify the above information

Driver License Copy Here
 
Driver License Copy Here

I,             Name of the travel agent) of            (Name of
the travel agency) have checked the signature , the original credit card, the driver
license of the credit card holder, and the address of the card holder are correct. I
will pay the charge amount plus handing charge if there is any charge back.
 
                            
Authorization Signature     Date