CC Authorization Globax Form

Name:

Address:

City:

St:

Zip:

Phone:

Circle One:

Visa Master Card AMEX

Credit Card:

Expiration Date:

CVV Code:

•Card holder agrees to pay total amount due according to card issuer agreement

Card Holder's Signature:

Date:

Choose your Driver license or Identification Image

Globax limousine is herby authorized to charge the above shown credit card for all transportation charges that are provided at my request. This authorization, once, signed, is valid whether or not a charge slip/imprint has also been signed. All informaton is considered and treated as confidential

Cancellation Policy: Any sedan services cancelled two(2) hours prior to the scheduled pick-up time will be subject to a service fee equal to the cost of the entire trip. The cancellation period shall six(6) hours notice for vans, minibuses, limousines, and SUVs. Motorcoach and specialty vehicles requre 48 hour notice.

Please check one of the following:

This authorization is to be put on file and used for all future orders until I notify you in writing to discontinue use of the above card.

This authorization is good for the following dates:

This authorization is good for the following orders:

Confirmation/Invoice

Amount to be charged:

(Extra charges may apply due to the trip length, other services provided, unscheduled stops, etc.)

Will the cardholder be the only person booking/using the service?

If no, please complete:

The person(s) named here may sign the driver’s trip ticket and charge his/her trip to my credit card listed.

Name of Person(s)