CREDIT CARD AUTHORIZATION FORM

CREDIT CARD AUTHORIZATION FORM

Explanation This document will enable us charging your credit card for the services mentioned below

Name of the person __________________________________________

Number of package P1        P2        P3        P4        P5         (Please mark the proper one)

Number of person ____

Name of the credit card holder __________________________________________

Total fee will be charged _________ US$ / _________ EUR / _________ GBP (Please pick suitable one)

Service will be handled by DEREN KORAY TOURISM - PsoriasisFishCure.com

Additional info __________________________________________

Card Type [ ] VISA               [ ] MASTERCARD             [ ] AMERICAN EXPRESS

Card Number
__   __   __   __

__   __   __   __

__   __   __   __

__   __   __   __

Security code of the card    __ __ __ The last three number of the backside (Please write clearly in both sections)

Expiry date Month ________   Year ________

AUTHORIZATION

Explanation I authorize DEREN KORAY TOURISM to charge my credit card by accepting the terms and conditions for the purpose of providing the services above

Signature ___________________________________

Current Date ______/_______/______

IMPORTANT ! Please fax this form to +90 232 4410437. Thank you

CREDIT CARD AUTHORIZATION FORM
Explanation	This document will enable us charging your credit card for the services mentioned below
Name of the person	__________________________________________
Number of package	P1 P2 P3 P4 P5 (Please mark the proper one)
Number of person	____
Name of the credit card holder	__________________________________________
Total fee will be charged	_________ US$ / _________ EUR / _________ GBP (Please pick suitable one)
Service will be handled by	DEREN KORAY TOURISM - PsoriasisFishCure.com
Additional info	__________________________________________
Card Type	[ ] VISA [ ] MASTERCARD [ ] AMERICAN EXPRESS
Card Number	__ __ __ __	__ __ __ __	__ __ __ __	__ __ __ __
Security code of the card	__ __ __ The last three number of the backside (Please write clearly in both sections)
Expiry date	Month ________ Year ________
AUTHORIZATION
Explanation	I authorize DEREN KORAY TOURISM to charge my credit card by accepting the terms and conditions for the purpose of providing the services above
Signature	___________________________________

Current Date	______/_______/______
IMPORTANT !	Please fax this form to +90 232 4410437. Thank you