EmailMe Form - Your Vacay Pay

Name
First Middle Last
Name as it appears on your invoice.
Phone
### - ### - ####
Email *
This email will be used for sending any electronic documents/itineraries.
Billing Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Booking # (only applicable if booking # provided)
By entering your booking # you are authorizing us to make payment on your behalf to the supplier of your booking.
Authorized amount to be Charged *
$ Dollars . Cents
Payment amount you are authorizing us to make payment on your behalf to the supplier of your booking.
Card Type *
Name on Credit Credit
First Middle Last
Name on credit card must be the person making the payment.
Credit Card

Card Number

Protected in vault Data collected via fields that have our security seal are encrypted and stored with the highest global security standard — PCI compliance. Your data is absolutely safe in Vault.
Confirm Billing Zip Code *
Be sure to enter information correctly, an incorrect entry can yield duplicate pending charges
Passport Number if Needed
Passport Expiration
Date of Birth *
Be sure to enter information correctly, an incorrect entry can yield duplicate pending charges
Known Travel Number, if Available
Identification Upload Photo (jpg, pdf, png files only) *
Name on ID must match name on the card used for payment.
CREDIT CARD PAYMENT AUTHORIZATION
I hereby authorize my travel agent to apply my payment to the travel vendor of my booking via the credit card listed above. I guarantee and warrant that I am the legal cardholder for the credit card information listed above and that the billing zip code matches the credit card information provided.
Authorization of Future Charges *
I do not authorize future payments. I will submit a new inquiry for future payments
I want to authorize future payments owed towards the balance of my travel booking to be charged to the above credit card with the same terms as disclosed above.
**Send future authorized payment requests via email: book@all-in-onetravel.com

In your email include your name, booking #, payment amount, and state that you authorize payment with the credit card ending in the last 4 digits of the card on file to be used for payment.
Notes
Signature
Clear
Date Time
MM / DD / YYYY

CREDIT CARD PAYMENT AUTHORIZATION