Updated June 09, 2023
An airline credit card authorization allows a passenger to pay for their ticket by completing the form and signing. The form serves as consent by the payor to authorize the credit card for the passenger. This is common when a business or individual is paying for a ticket on someone else’s behalf.
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
___________________________