Credit
Card Authorisation
For your convenience we are accepting
payments by credit card. However, for your security we are not
accepting credit card payments online.
TO GIVE 'NAXOSVISION - RENT A CAR'
THE LEGITIMATE RIGHT TO TRANSFER YOUR PAYMENT TO OUR BANK ACCOUNT, WE
KINDLY ASK YOU TO PRINT THIS AUTHORIZATION FORM, FILL IN THE
FOLLOWING PERSONAL DETAILS AND THEN FAX THE DATA TO OUR OFFICE.
(FAX NO.:
+30 22850 26201)
NAME:
....................................................................
ADDRESS: ..............................................................
POST CODE: ...........................................................
COUNTRY: ...............................................................
TELEPHONE: ...........................................................
MOBILE: ...........................................
FAX:
........................................................................
E-MAIL:
...................................................................
TYPE OF CREDIT CARD:
VISA WITH NUMBER: ......................................................
MASTER CARD WITH NUMBER: ......................................
EURO CARD WITH NUMBER: ..........................................
AMERICAN EXPRESS WITH NUMBER: .............................
ANY OTHER CREDIT CARD TYPE:
...........................................
........................................... WITH NUMBER:
.............................
VALID UNTIL: ...................................
THE UNDERSIGNED DECLARES HEREWITH THAT NAXOSVISION RENT A CAR,
REPRESENTED BY MARIA VITZILEOU, MANAGING DIRECTOR OF NAXOSVISION RENT A
CAR, HAS MY PERMISSION TO TRANSFER EUROS
......................................... (AMOUNT) FROM MY CREDIT CARD
ACCOUNT TO HER ACCOUNT.
DATE: .....................................
PLACE: ...................................
SIGNED: ..................................
