Payment form

Thank you for trusting KCB Travel for your travel plans. Please complete the following form with your payment information so it can be applied to your upcoming trip. If you have any questions or concerns, please don't hesitate to contact me at kelly@kcbtravel.com.

Your completion of this authorization form helps us protect you, our valued client, from credit card fraud. All information entered on this form will be kept strictly confidential. If you are a new client, you must provide a clear copy of the cardholder's picture ID (please no military IDs) or by return of this form alone your travel advisor is acknowledging that you are known to him/her.

NOTE: If you are using a debit card with a daily spending limit, it is your responsibility to contact your bank to give them permission to authorize the transaction. If they require the name of the vendor and you are unsure as to who that is, please contact us.

PAYMENT INFORMATION

Card Type:

Expiration Date

Month

Year

CVV Number

Amount to Pay Now: $

BILLING INFORMATION

NOTE: If you are using a debit card with a daily spending limit, it is your responsibility to contact your bank to give them permission to authorize the transaction. If they require the name of the vendor and you are unsure as to who that is, please contact us.

In lieu of my credit card imprint I acknowledge that I am the cardholder listed herein, and authorize KCB Travel to charge my credit card for the travel related charges above. I understand all the terms and conditions of this booking and agree to the terms and conditions provided to me for this travel arrangement, including all cancellation policies. I understand and agree that travel arrangements may be subject to non-refundable cancellation penalties. I further understand that as part of my travel services, KCB Travel has recommend that all travelers purchase some form of travel insurance to help protect their travel investment.

If this document is signed on behalf of the cardholder, the signatory has been authorized by the cardholder and cardholder accepts all responsibilities for charges.

I certify that the information provided on this form is true and correct. I am authorized to effect charges on the credit card number provided. I agree that in the event of a discrepancy to my credit card account, I will notify your agency's accounting department within seven (7) business days of receiving the credit card statement or immediately upon knowledge of such error.

As the credit card holder, I authorize KCB Travel to charge my credit card for future purchases approved by me, either verbally or written including electronic communication.

By clicking the "Submit My Payment" button, you are electronically agreeing to the above.

Authorization Valid until date of travel or 1 year from date of submission, whichever is sooner.

I am authorizing KCB TRAVEL LLC to charge my card referenced above in the amount indicate and agree to KCB TRAVEL LLC'S terms and conditions of booking, which are located at this link.

This form collects payment information, but will not automatically charge your card. One of the staff members at KCB TRAVEL will process this payment typically within 1-3 business days.

KCB Travel

904-453-8800

Kelly@kcbtravel.com