ACH Form

ACH Form

ACH Authorization Form
Please Fax this to (617) 701-1750 or scan it as a PDF FILE ONLY to alanita@alanitatravel.net
This form must be FULLY completed before tickets can be issued.
To: Alanita Travel®, 87 Common Street, Watertown, MA 02472 Ph: (617)923-4810 Fax No:(617) 701-1750

ONE TIME ACH PAYMENT AUTHORIZATION FORM

By signing this form you gave us permission to debit your account for the amount indicated on or after the indicated date. This is permission for a single transaction only, and does not provide authorization for any additional unrelated debits or credits to your account.

**Please check your itinerary for name spellings. We do not use this page for spelling corrections***

I, (Account holder) authorize Alanita Travel® to charge my bank account indicated for $ (amount) on or after (date),and request Alanita Travel® to issue the tickets below. I am aware that the conditions of my airline ticket are not mentioned here and that these conditions are stated in my itinerary.I am responsible for all the conditions of the tickets I am authorizing to be issued.

BOSTON


87, Common Street, Watertown,
MA 02472, USA

617-923-4810 | 888-465-4282
617-701-1750
alanita@alanitatravel.net

Hyderabad


Plot No:56,Unit No:101,
New Mark House,Patrika Nagar,
Madhapur Village,Sherlingampally,
Hyderabad Telangana-500081

040-4953-2535
617-701-1750

Chennai


No. 44 Krishnashree Building First Floor,
First Main Road Gandhi Nagar,
Adyar, Chennai Pin-600020

044-2442-0712 | 2445-2329 | 2445-2330 | 2445-2331
617-701-1750
alanita@alanitatravel.net
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