Credit Card Authorization Form

Welcome to Heart Of Travel

Credit Card Consent Form

First Name

Last Name

Phone/Mobile

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Valid ID of Person Giving Consent

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Selfie of card owner holding the credit card

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Credit Card - Front

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Credit Card - Back

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I authorize Heart of Travel to charge my credit card for the goods/services described. I confirm that I am the authorized holder of this credit card and that the billing information provided is accurate.

I understand that this authorization will be used primarily for Heart of Travel transactions. Additionally, I consent to Heart of Travel keeping my credit card information on file as a backup payment method. If any pre-authorized debit (PAD) payment does not go through, Heart of Travel is authorized to charge my credit card for the amount due for future transactions.

I agree to notify Heart of Travel immediately in case of any changes to my credit card information or if I suspect any unauthorized use of my card.

Click 'Agree' if you agree to the terms and conditions.

Agree

Signature

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Date