Please print, sign, and fax this
form to +(506) 2290-2853 (506 is C.R.'s country code)
For security reasons for
transmitting credit card information over the internet, we have
established this secure form of payment.
The following form must be
filled out completely for us to accept Visa
I_________________________________authorize
Turismo Expertos de Costa Rica S.A.
(Cardholder's name as it appears on the
credit card)
to charge $_______ on my VISA credit card.
VISA Card # __________________
Exp. Date ______________Issuing Bank
________________________________
Passport #_______________ Date of birth ________
Mother's maiden name ________________________
Address____________________________________________________________
Address on Visa Acct. (if different)
_______________________________________
Daytime phone #____________ Fax #:___________ E-mail
Address:_____________________________________________________________
I have read and accept the
conditions of the reservations and I agree to pay the amount
here authorized, even though I have not signed the original
charge note or voucher. I agree to pay this amount in case of
"No Show". I understand that, in case of cancellation, I am
responsible for all penalties charged by individual suppliers.
I have
read and accept the conditions specified in our Terms &
Conditions page
www.transportationcostarica.com/termsconditions.htm and I
agree to pay the amount here authorized, even though I have not
signed the original charge note or voucher. I agree to pay this
amount in case of "No Show". I understand that, in case of
cancellation, I am responsible for all penalties charged by
individual suppliers and by Costa Rica Travelsite.
Transportation
Costa Rica will be happy to
supply cancellation information for any item on your itinerary
Photocopy
of Credit Card (front and back)
Credit Card Holder's
Signature:_____________________________ Date:______
Costa Rica
Transfers, Main Office
San Jose, Costa Rica
Telephone: (506) 2290-2878 / Fax: (506) 2290-2853
