SECURE CREDIT CARD SUBMISSION FORM
Use this form if you would like to securely submit a credit card for payment of an existing booking. Please see Consumer Disclosure Notice at www.NMTC.us
SHORT DESCRIPTION OF WHAT YOU ARE PAYING FOR:
Booking ID - Not needed for Deposit
AUTHORIZED AMOUNT TO CHARGE:
(If you are using a debit card, please insure your bank is aware of the amount as they usually have a daily limit of $1000 - $1500)
NAME ON CARD:
Credit Card Type
Credit Card Number
Expiration Date (mm/yy)
SECURITY CODE (3 digits on back or, in the case of American Express, 4 digits on front):
Billing Street Address
Address Line 2
I agree that cancellation of any deposited booking by the client may result in an agency cancellation fee of up to $200 in addition to any possible penalties by the supplier. If this cancellation penalty is assessed, I agree to pay it PRIOR TO cancellation of the booking.
I am aware that Travel Protection is available through the provider and/or John Hancock Insurance and that it is my decision as to whether to purchase it or not.
If traveling outside the continental U.S. borders, I am aware that I am required to submit a negative Covid-19 test to the airlines within 3 days of my return to the continental U.S., at my own cost. I am also aware that should the test return a positive result, I am responsible for all costs for the quarantine period extension until I can return. including any airline change fees, additional room and board and meals.
Agent working with you