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 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 outbound date changes before departure date are $375 USD plus any applicable fare and tax differences. I am aware return date changes are $375 USD plus any applicable fare and tax differences. 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

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

Yours truly,

Signature here: X__________________________________ Date:____________________