ZEiNO :: the travel experts

1.) Please print out this form. 2.) Complete all of the fields applicable to you. All fields in bold are required. 3.) Sign the form and print your full name. 4.) Fax the form back to ZEiNO at (415) 564-4303.

Substitute Universal Credit Card Charge Form

DATE ________________

IN LIEU OF MY CREDIT CARD IMPRINT, I _______________________________ (NAME OF CARDHOLDER AS SHOWN ON CREDIT CARD ) HEREBY AUTHORIZE

__________________________ (ISSUING CARRIER / TRAVEL AGENT NAME) AIRLINE /ZENO TRAVEL TO CHARGE MY

____ Visa ___ MasterCard __ American Express (Credit Card Type)

_____________________________
Credit Card Number

___/___/___
Expiration Date

___________
Security Code

$______ USD FOR PAYMENT OF TRANSPORTATION OF MYSELF AND/OR
Amount To Charge

___________________________________________
Full Name(s) of Passanger (s) if other than Cardholder

___________________________________________
Billing Street Address

___________________________________________
Billing City, State, Zip

NOTE: Identification is required. Please provide Photostat copy of the credit card (front and back ) and passport or driver's license of the cardholder .

By signing below, I acknowledge charges described hereon. Payment in full to be made when billed or in extended payments in accordance with standard policy of the company issuing the credit card.

_______________________ Cardholder Signature	_______________________ Printed Name

Telephone: (415) 564-4353	Weekend Telephone: (415) 287-3612
Facsimile: (415) 564-4303	Electronic Mail: 888@zeino.com

DESTINATIONS: EUROPE, ISRAEL, HAWAII, MEXICO, COMMONWEALTH STATES, AFRICA, ORIENT'S AMERICA

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