台北国际联合旅行社（股）公司.doc

台北國際聯合旅行社(股)公司 Taipei International Joint Travel Service Company 信用卡扣款同意書 Credit Card Payment Agreement 本同意書於取得信用卡授權號碼後生效，本公司保證依您指示辦理旅遊/機票等業務如下列：茲確認本人委託台北國際聯合旅行社股份有限公司承辦以下項目（※表必填） This agreement will take effect after obtaining the credit card authorization number. The Company hereby agrees to handle the travel / ticket transactions and I hereby confirm that I entrust the Taipei International Joint Travel Service Co.Ltd. to undertake the following. (※ form is required) 出發日期： Departure Date 團名： Tour Name 項目: 團費 Project: Tour Fee Credit Card Number:口口口口-口口口口-口口口口-口口口口 ※ CVV Code (last three digits) ※ Card Type:口VISA　umber : (Landline)　　　　　　　　　　　（Cell-phone）　　　　　　　　　　　 Cardholder’s Signature：　　　　　　　 　　　　　※（must match the signature on the back of the credit card) 商店代號：000812870100460 台北國際聯合旅行社股份有限公司 Company Code Number : 000812870100460 Taipei International Joint Travel Service Co.Ltd 本人同意上述所有款項，以上列信用卡帳戶支付於台北國際聯合旅行社股份有限公司， 且本人同意授權以上列信用卡資料支付旅遊/機票等相關費用 I agree and authorize for the above credit card account to pay the stated amount to Taipei International Joint Travel Service Co. Ltd. I agree to authorize the above credit card information to pay for travel / ticket and other related costs. 活動統籌: 請將填好的刷卡單e-mail 至PEP_Service@ 本活動費用為 美金500元 Please e-mail the completed credit card form to PEP_Service@ The total cost of this event is $500 USD ☆☆本傳真刷卡單請保留２０個月以上，以保障您自身的權益☆☆ Please keep record of this form for at least 20 months