Backup Form



BackUp Only Form

* Back up Only * Back up Only * Back up Only * Back up Only *
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
Please Fax this to (617) 701-1750 or scan it as a PDF FILE ONLY to alanita@alanitatravel.net

I, (Credit card holder's Name) request Alanita Travel® to issue the tickets below and authorize Alanita Travel® / SLT / CTS / TAT / MRT to charge my credit card for the amount listed below in the event that my other form of payment is not received within 5 business days of the date on this form. I am aware that Alanita Travel® will take an "authorization" on my credit card for the amount on this form, but the card will only be charged in the event that I do not make some other form of payment within 5 days of the date on this form. This "authorization" on the credit card will be active for a period of 15 business days. I am aware that all tickets are non refundable. I am aware that all the tickets are non-transferrable and non-refundable; in-case of refundable ticket - I am aware the penalty may vary from $375 and above per ticket. I am aware if my ticket is changeable, any airline penalties plus any applicable fare and tax differences for date change for both used and unused tickets, will be applied based on the airlines. In addition to the airline fees, there will be a service fee of $25.00 per passenger charged by Alanita Travel. I am also aware that the airline that I am purchasing may not accept credit cards so it may not be possible for me to receive any additional benefits or insurance offered by my credit card company.In case of any legal disputes, all claims must be brought in a court located in Middlesex County, State of Massachusetts, USA.

Alanita Travel® is not responsible for seat assignment, Frequent Flyer numbers, meal preference or VISA REQUIREMENTS of any kind

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

Passenger 1:
Passenger name as on the passport: (Last name/First name)

Date of birth:
Gender:

Passenger 2:
Passenger name as on the passport: (Last name/First name)

Date of birth:
Gender:

Passenger 3:
Passenger name as on the passport: (Last name/First name)

Date of birth:
Gender:

Passenger 4:
Passenger name as on the passport: (Last name/First name)

Date of birth:
Gender:
Airline
Cardholder Name(s):
Cardholder Phone (H):
Cardholder Phone (W):
Passenger's Phone No. in India:
Passengers Email ID:
Credit Card Type
(No Debit Cards or Corporate cards)
Credit Card Number:
Expiry Date:
Total amount to be charged:
(4.5% CC fee will be added to this amount)
Billing Address:     Add:
Add:
City:
State: Zip Code:
Issuing Bank:
Bank Customer service Tel:

Alanita Travel will email you updates for special sale fares and promotions Please check this box if you would not like to receive these emails:

Please send a copy of your credit card front and back *lighten copy please

*You also acknowledge - "In-case-of any legal disputes, all claims must be brought in a court located in Middlesex County, State of Massachusetts, USA."

Yours truly,

Signature here: X__________________________________ Date:____________________