Date Change And Authorization Form



Date Change And Authorization Form

***This form must be FULLY completed before date changes can be made.***


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 to make the following date changes noted below and authorize Alanita Travel ® / SLT / CTS / MRT / TAT to charge the amount listed below.

- Alanita Travel® is not responsible for seat assignment, Frequent Flyer numbers, meal preference or VISA REQUIREMENTS of any kind
- If your ticket is refundable or changeable, it must be canceled more than 24 hours before departure to be eligible for refund or date changes
-In case of any legal disputes, all claims must be brought in a court located in Middlesex County, State of Massachusetts, USA.

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

Names of Passengers:(Last Name / First Name)

1. 2.
3. 4.

*If passengers are not flying on same dates as each other, please fill out separate forms for each passenger.

Airline:

Departure Date changed From :

MM DD
YY
To: MM DD
YY
Return Date changed From : MM DD
YY
To: MM DD
YY
Cardholder Name(s):
Cardholder Phone (H):
Cardholder Phone (W):
Passenger's Phone No. in India:
Passengers Email ID:
Credit / Debit Card Type
(No Corporate cards accepted)
Credit / Debit Card Number:
Expiry Date:
Total amount to be charged:
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

Yours truly,

Signature here: X_____________________________ Date:____________________