Alanita Travel - 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 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

**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 Card Type
(No Debit Cards or Corporate cards)

Credit 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:____________________