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Credit Card

Authorize payment for airline tickets, resort/hotel, and cruise reservations. Split payments supported.

Cardholder / Billing Information

Name
Address
Reservation / Trip Name
MM slash DD slash YYYY

Payment Details (Split Payments Supported)

MM slash DD slash YYYY
MM slash DD slash YYYY
MM slash DD slash YYYY

Card Details (Processed securely by supplier when possible)

Card Type
Name
Please enter a number from 0 to 3.
Billing ZIP
Security tip: If emailing, use a secure method. You may provide card details by phone; if emailing, mark you card to last 4 digits in attachments

Authorization & Terms

I authorize Terry’s Blissful Travel - Terry Lynch and/or its supplier partners (airline, cruise line, resort/hotel) to charge my card for the amounts listed above. I understand charges may be processed directly by the supplier and are subject to their terms, including cancellation and refund policies. I certify that I am the authorized cardholder

Authorization
MM slash DD slash YYYY

Please return this form with a copy of your photo ID (and optional masked card image showing last 4). Email: [email protected]

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Contact Information

Phone :  (623) 533-1541

Email: InfoTerrysBlissfulTravelcom

Address: Based in Arizona, USA

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