Customer Name (Please print):

 

____________________________________________________________

                                                                                          

Date: _______________________________________________________

 

 

Independent Travel Agent: ____________________________________

 

PIN:  ______________________________

 

Agent Tel: __________________________________________________

 

Email: ____________________________________________________

 

 

TRAVEL PURCHASE AUTHORISATION - For Non-Website Purchases

Thank you for your purchase. lnteleTravel.com is pleased to confirm your travel arrangements. To complete your transaction and confirm your arrangements, please sign and return this form to your travel agent. This form is NOT required for electronic purchases you may complete yourself, on our websites, www.lnteletravel.com , www.lnteletravel.uk or our affiliates. Charges are payable ONLY to lnteleTravel, or the hotel, resort, tour operator, cruise line or other travel supplier. Independent Travel Agents may not accept and process charges through any other account, accept cheques, cash or other forms of payment.

 

 

TRAVEL INSURANCE WAIVER

 

For your protection, Travel Insurance is strongly recommended and easily available. Travel insurance should be confirmed on the date of booking your trip to avoid unforeseen costs of cancelling or curtailing your holiday. Please ask your travel agent for the preferred insurance provider, Journeys Insurance. You will receive a unique link to forward to our insurance partner, for your quote.

To decline our recommended travel insurance, your signature on this insurance waiver form is required.

Final Travel Documents (tickets, vouchers, etc.) will not be sent to you until we have received the signed insurance waiver form.

 

I,____________________________________________________________________, authorise lnteleTravel.uk and/or the affiliated travel supplier:

​

 

____________________________________________________________________,_________________________________________________,

to charge my: (Please select one)

​

AMERICAN EXPRESS           MASTERCARD            

​

VISA CREDIT                          VISA DEBIT

​

​

Credit Card Number: _________  _________  _________  _________

 

Expiry Date:                                                  

 

CVC: _______ (last 3 digits)

 

 

First Line of Address:  ________________________________________

 

Town: _____________________________________________________

 

Postcode: ________________

 

For the amount of £ _________________________________________

 

 

For the following travel arrangements: _______________________________

 

 

 

 

Itinerary details: ________________________________________________

 

 

 

 

 

Date of Travel:               _________________________________________

 

Booking reference:          _______________________________________

 

 

 

 

 

Passengers (Please state full names as per passport)

 

Main Passenger: _______________________________________________

 

Second Passenger: _____________________________________________

 

Third Passenger: _______________________________________________

 

Fourth Passenger: _____________________________________________

 

 

PLEASE SIGN ON THE LINE WHICH APPLIES

 

I accept and authorise the travel purchases as stated, including travel insurance, and I am aware the insurance premium is not refundable.

 

Customer Signature: ___________________________________________

 

Date: _____________________________________________________

 

 

OR

 

I accept the authorised travel purchases as stated, and understand that by signing below, I am DECLINING TRAVEL INSURANCE. I have read and understand all cancellation charges and change fees related to the above travel arrangements, and that I may not be entitled to a full refund should my travel plans change. In case of cancellation of non-refundable airline tickets or other arrangements, I agree to pay all applicable penalties according to the travel supplier's terms and conditions.

 

Customer Signature: ___________________________________________

 

Date: _____________________________________________________

 

IMPORTANT:

Please attach a legible copy of the front and back of your credit card.

 

All information stated here are accurate and correct at this time, but subject to change until payment has been received and this form returned. See www.lnteleTravel.uk for full terms and conditions.

 

 

lnteletravel UK Ltd is registered in the UK (company reg: 10983417) 25 Cabot Square

Canary Wharf London E14 4QZ

 

Auditor address: 109 South Worple Way, London SW14 8TN