付款同意書 - TransAsia Airways.docVIP

電子機票/付款資料確認同意書 旅客 先生/女士等 人所持之電子機票付款者為 先生/女士,於 年 月 日搭乘復興航公司 GE 班機 由_______前往_______。 因使用電子機票有下列情形並產生任何後果時，免除復興航空或相關第三者一切責任，並願意支付或賠償復興航空或相關第三者之機票款或損失。 因無法提供適當身份證明為電子機票之所有權人。 無法提供適當付款證明或信用卡資料不明確。 付款者未依規定與同一訂位行程之旅客同行。 其他因素。請註明原因：____________________________________ __________________________________________________________ 簽署人資料：(搭機者) 姓名：_________________先生/女士 電話：_________________ 地址：_______________________________________________________ 身份證/護照號碼：____________________________________________ 原信用卡號碼： ____________________________________________ 新信用卡號碼： ____________________________________________ 復興承辦人員_____________________日期：_______年_____月_____日 (請搭機當日攜帶此同意書至機場櫃檯辦理報到,復興航空感謝您的配合。) E-ticket / Payment Confirmation Consent The passenger Mr./Ms.__________ with accompany total ____ passengers, who held the e-ticket with its payments paid by Mr./Ms ___________, take flight from GE _____ from _______ to _______ on _____/___/___(yyyy/mm/dd). For using the above electronic tickets and any of the following circumstances and consequences resulting, will exempt TransAsia Airways or relevant third party all liability and responsibility. Are willing to pay or compensate TransAsia Airways or relevant third party the loss of airline tickets. □ inability to provide proper identification for the e-ticket the owner. □ not provide adequate proof of payment or the credit card information is not clear. □ The credit card payment Payer not able to travel with the passenger within the same booked itinerary. □ other reason. Please specify: ______________________________________ _____________________________________________________________ Sign of Passenger data: Name: _________________ Mr. / Ms. Phone: _________________ Address: ______________________________________________________ ID card / passport number: _________________________________________ The original credit card number: ____________________________________ New Credit Card Number: ___________