Credit Card Charge Authorization
Travel Agents Incorporated
9415 N May Avenue
Oklahoma City, OK 73120
Phone (405)752-5252 Fax (405)752-7020
Please fill out this form fax to (405)752-7020
In lieu of my credit card imprint, I ____________________________________, hereby authorize
(print name of card holder as shown on the card)
Travel Agents Incorporated to charge my: Visa MasterCard American Express Discover
(circle one)
credit card number ______________________________________ with an expiration date of ___/___
(mm/yy), security code ______ (3 digits on the back of the card) in the amount of $________________
for the payment of myself and/or _________________________________________________________
(full name of traveler if other than the cardholder).
Billing Address of Credit Card:
Street: _____________________________________________ Apt or Suite# _______________
City: ______________________________________, State ______, Postal Code ____________
Home Phone: _________________________ Cell Phone: _________________________
Work Phone: __________________________
Email:_________________________________________________________________________
****PLEASE PROVIDE LEGIBLE FRONT AND BACK COPIES OF THE CREDIT CARD AS WELL AS A FRONT COPY OF THE CARD HOLDER’S DRIVER’S LICENSE****
By signing below, I agree to the charges described hereon and authorize T.A.I. to process the above credit card
for these charges. I agree to pay in full these charges in accordance with the standard policy of company
issuing the credit card. I acknowledge that I have read and fully understand the T.A.I. terms,
conditions, and cancellation policy (click Here) and I agree to those conditions. Under penalty of
Federal laws and the laws of the state of Oklahoma. I certify the foregoing is true and correct.
Please Read, Sign, Date and Return a copy of the Terms and Conditions.
Signature _________________________________________________________ Date _______________
Printed Name __________________________________________________________________________