Airline Credit Card Authorization Form

An airline credit card authorization is used to allow an airline passenger to pay for their ticket with a credit card that is not in their name. The form serves as consent from the cardholder for the passenger to use their card. It is commonly used when a business or individual is paying for a ticket on someone else's behalf.

Updated January 07, 2025

By Airline

Sample

AIRLINE CREDIT CARD AUTHORIZATION

PLEASE ATTACH THE FOLLOWING ITEMS:

1.) This Credit Card Authorization Form;
2.) Photocopy of Credit Card (both sides); and
3.) Photocopy of Driver’s License or Passport Picture (signature page)

Airline Reference Code (if any): [SIX DIGITS]

NAMES OF ALL TRAVELERS USING THIS CARD:

1.) NAME: [NAME OF TRAVELER 1] AGE: [#] DOB: [DAY OF BIRTH]
2.) NAME: [NAME OF TRAVELER 2] AGE: [#] DOB: [DAY OF BIRTH]
3.) NAME: [NAME OF TRAVELER 3] AGE: [#] DOB: [DAY OF BIRTH]
4.) NAME: [NAME OF TRAVELER 4] AGE: [#] DOB: [DAY OF BIRTH]
5.) NAME: [NAME OF TRAVELER 5] AGE: [#] DOB: [DAY OF BIRTH]

CARD TYPE:

☐ VISA ☐ MASTERCARD ☐ AMERICAN EXPRESS ☐ DISCOVER
☐ OTHER: [DESCRIPTION]

Cardholder’s Name: [FULL NAME]
Card Number: [CARD NUMBER]
CVC Number: [3 OR 4 DIGITS]
Expiration Date: [DATE]

BILLING ADDRESS (where you receive statements): [BILLING ADDRESS]

Cardholder’s Phone: [PHONE NUMBER]

I hereby authorize [NAME OF AIRLINE] and its suppliers and/or designees to charge my card in the amount of $[AMOUNT] for the payment of tickets for the above-mentioned travelers and agree to the terms and conditions of said payment.

CARDHOLDER’S SIGNATURE

___________________________ DATE: ________________

Print Name

___________________________