Please complete the bottom portion of this form by clicking here.
By signing below, I authorize WE Travel Agency USA to charge the credit card provided herein.
Independent Travel Advisor: PIN:P161869
TRAVEL PURCHASE AUTHORIZATION For Non-Website Purchases. Thank you for your purchase.
InteleTravel.com is pleased to confirm the following travel arrangements. To complete your transaction and confirm
your arrangements, your signature on this authorization is required. This form is NOT required for electronic purchases
you complete yourself on our website, www.InteleTravel.com, or its affiliates. Charges are payable ONLY to
InteleTravel.com or the hotel, resort, tour operator, cruise line or other travel supplier. Independent Travel Advisors
may not accept and process charges through any other account, or accept checks, cash or other forms of payment.
TRAVEL INSURANCE WAIVER
For your protection, Travel Insurance is strongly recommended and available upon request from
InteleTravel.com. You can enroll online for travel protection for Medical Expenses, Baggage Delays/Loss, Trip Delay
or Cancellation, and other coverage, or your InteleTravel.com Independent Travel Advisor can arrange coverage for
you. For an online insurance quote and purchase, go to www.InteleTravel.com and click on Insure It.
To decline recommended travel insurance, your signature on this insurance waiver form is required. Final
Travel Documents (tickets, vouchers, etc.) cannot be sent to you prior to receipt of the signed insurance waiver.
I, , authorize InteleTravel.com and or this travel supplier:
, to charge my:
(check one) AMERICAN EXPRESS MASTERCARD VISA DISCOVER
Credit Card Number : Expiration Date:
Billing Address: CVV:
For the amount of on the cc authorization form (USD)
PLEASE SIGN ON THE LINE WHICH APPLIES
-------------I have ACCEPTED and authorized the travel purchases above, including travel insurance, and I am aware the
insurance premium is not refundable.
Customer Signature: Date
------------I have ACCEPTED and authorized the travel purchases above, and I understand that by signing below, I am
DECLINING TRAVEL INSURANCE. I have read and understand all cancellation charges and change fees related to
the above travel arrangements, and that I may not be entitled to a full refund should my travel plans change. In case
of cancellation of nonrefundable airline tickets or other arrangements, I agree to pay all applicable penalties according
to the travel supplier’s rules.
Customer Signature: Date
IMPORTANT: Please attach a legible copy of the front and back of your credit card.
All rates subject to restrictions, availability and change. See www.InteleTravel.com for complete terms and conditions.InteleTravel.com is
registered with the States of Florida (ST-32452), Washington (602-735-106), California (209-1941-40), Iowa (977), and Hawaii (TAR 6732) as a
seller of travel. InteleTravel.com uses the personal data you disclose about yourself on this form only for the purpose of processing your
requested travel purchase. We retain your personally identifiable data only as long as that processing requires. We do not share any of your
personal data with any third party except for the purpose of completing your purchase, and then only with third-party travel providers and credit
card processors who protect and only process your personal data for the limited purpose of this travel purchase. Following the completion of your
travel that is the subject of this transaction, your personal information shall be securely destroyed unless InteleTravel.com is required by law to
retain it, and then it will be retained only for that limited legally required purpose. For complete details regarding the protection of your personal