EmailMe Form - PAYMENT AUTHORIZATION FORM (Supplier)

PAYMENT AUTHORIZATION FORM (Supplier)

SUNBREEZE TRAVEL LLC
Donna Riley (803) 702-1299
email:magil922@msn.com or donna@sunbreezetravel.com

I understand this is a disclosure of business practices and permissive payment agreement for the purchase of travel services. I agree that payments may be made direct to selected travel suppliers on my behalf by Sunbreeze Trave LLC paid in prorated amounts not to exceed the sum total of approved charges (stated and written). I understand Debit Cards often impose “Daily Charge Limits” and multiple payments may be needed to complete the full balance due. I am aware of any potential Cancellation, Refund and Surcharge Policies and Fees by suppliers and agree not to dispute or chargeback any of the above signed for and acknowledged charges without proper course of action. I understand that Sunbreeze Travel LLC will impose the following charges when contractually applicable: all non-insured reservations are subject to Cancellation Fees of $35 per adult, and when applicable, Booking Transfer Request Fees of $90 per adult will be applied to the provided credit card account. Sunbreeze Travel LLC will not release personal information to ANY parties not listed on your finalized Travel Contract and will apply due diligence in maintaining records in a secured, safe location.
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Name
First Middle Last
Legal name as on government issued identification. Name as it appears on passport required for international travel
Supplier Name *
Name of Cruise Line or Other Supplier Name - NOT THE TRAVEL AGENT NAME OR BUSINESS
Booking Number *
IF YOU DO NOT YET HAVE THE BOOKING NUMBER PUT N/A
Travel Destination *
Total Package Price Quote (found on quote in email/invoice or conveyed directly to client)
This is the Total Package Quote, which includes anticipated payments to be prorated to various suppliers; such as airlines, hotel, cruiseline, resorts, insurance, excursions and guest services-as dictated in the Quoted Travel Package. Each identified charge will be confirmed by email on date prior to payment submission and confirmed by paid receipt. This amount subject to change with any additions/removal of travel activities. *
This amount is for cruise only - does not include air fare, hotel, transportation or any other travel expenses.
I have been informed of the supplier’s cancellation policies for travel services and agree to the supplier’s terms and conditions *
Please confirm by typing in your name
I have been informed of the benefits of travel protection and understand if purchased, the premium paid for the insurance is non-refundable. *
Please confirm by typing in your name
Cardholders Billing Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Cardholder's Phone Number *
### - ### - ####
Name as it appears on Credit/Debit Card *
First Last
Card Type
Credit Card *

Card Number

Please check and verify number before submitting

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.
I hereby authorize the below named supplier to charge the indicated credit
card listed above for the travel services stated above. I guarantee and warrant that I am the legal cardholder for this credit card. *
Type in name of Supplier
MINIMUM DEPOSIT and/or amount authorized today

MINIMUM DEPOSIT is amount required today to initiate reservation. (The date of travel, number of paying guests and supplier terms will be factored in computing required deposit amounts.) This amount is included in Total Package Quote provided in Email. You MUST pay the balance in full prior to Final Due Date or by date optional supplied by Sunbreeze Travel or the supplier.
$ Dollars . Cents
APPROVAL OF CHARGES
As named Cardholder; I Authorize: the supplier(named above) to immediately charge my credit card the above amount, as needed to complete the reserved Travel Package account for the Primary Traveler listed above. *
Please type your name/signature for approval
Email for Receipt & Confirmation *
This will be used for mailing any electronic documents/itineraries.

Confirm
FUTURE PAYMENT AUTHORIZATION
I authorize future payments as dictated by supplier or travel advisor timeline. These payments may be automatic as discussed with travel advisor and pre-authorized. All future payments due towards Total Package Cost, to be charged to the above credit card with the same terms as disclosed. I may opt to use a different Credit Card simply by submitting a new Authorization Form at least 3 days before payment date. *
Please type your name/signature for authorization
Checkbox *
Use Same Card for future payments
I want to use a different card for Future Payments
I understand that if I use another card for future payments that I must submit a new Authorization Form at least 3 days before payment due date.
Terms and Conditions:
This Disclaimer is a contract between Client and Sunbreeze Travel, LLC. Lawsuits against Sunbreeze Travel LLC must be brought only in Mechanicsville, Maryland and client consents to be sued in Mechanicsville, MD.

• Sunbreeze Travel LLC acts only as an agent for airlines, hotels, tour operators, and other suppliers of services and shall not be held responsible for any injury, loss or damage caused by accident or event beyond their control, or by any action or negligence of any persons who are not in their employ. Sunbreeze Travel LLC can accept no responsibility for losses or additional expenses due to delay or changes in air, sea or other services due to sickness, weather, strike, war, or other causes. Sunbreeze Travel LLC has no special knowledge of suppliers' financial condition. Sunbreeze Travel LLC is not responsible for events beyond its control such as strikes, disasters or terrorism and has no knowledge of destination dangers. Clients should check the State Department's travel advisories webpage and the Centers for Disease Control's travel webpage for destination health issues.The right is reserved to make adjustments in the itinerary if deemed necessary. Prices are accurate at time of quote and are subject to change until trip is paid in full.

• Passports : Clients are solely responsible for passport and Visa requirements. All international trips require a Passport valid for at least 6 months beyond the date of departure. Any and all additional travel documents required are the responsibility of the traveler.

• Air Travel : Flight details including departure times are always subject to change by the airlines and are not under the control of Sunbreeze Travel LLC. It is the travelers responsibility to check in for the flight 24 hours in advance and reconfirm all gates and times.

• Cancellations : Cancellation, revision and refund polices for changes or unused travel/components vary and are subject to the policies of each supplier. Cancellation penalties can range up to 100% depending on how close to departure the written notification is received. Air, insurance premium and no-shows are always non-refundable. Sunbreeze Travel LLC reserves the right to charge a $35 per person administrative fee payable before cancellation will be processed. All claims for refunds or damages must be filed within 15 days after the client's return. I agree that should I cancel and did not purchase trip protection that I forfeit all money paid. I ALSO agree that the cancellation fee must be paid prior to cancellation of booking.

• Travel Insurance : Sunbreeze Travel LLC may provide information on Travel Protection via a third-party vendor that can help minimize the monetary loss incurred due to unforeseen events beyond your control such as: cancellation, missed connections, baggage loss, trip delay, and especially medical emergencies. *
I AGREE