Colony Limo Service Houston Request a Quote Colony Limo Service Houston Request a Quote

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Credit Card Authorization Form

Trip Acceptance & Debit or Credit Card Signature for ...

Trip Confirmation No.*

Please type your trip confirmation number!

Full Name*

Please type first name!

Company Name

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Billing Information

Payment Type*

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Card Number*

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Expiration Year

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Expiration Month

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Please Input your credit card's security code!


Card Holder's Name*

Please type card holder name!

Address Line 1*

Please type credit card billing address!

Address Line 2

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City*

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State*

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ZIP Code*

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Contact information

Phone Type
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Phone Number*

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Email*

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Other Phone Number

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Fax Number

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Clear Copy of Credit Card

Note: Your photo format should be "JPEG", "JPG", "GIF" or "PNG" and it should not be more than 3.5MB in size.

Please include a clear copy of credit card holder identification!


Clear copy of card holder's ID

Note: Your photo format should be "JPEG", "JPG", "GIF" or "PNG" and it should not be more than 3.5MB in size.

Please include a clear copy of card holders ID!


Driver's License Number*

Please type your driver's licenses number!


A minimum of 50%, Non-Refundable deposit is required.

Deposit*

Please type authorized amount!

Date of Charge*

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Optional Payments?

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First authorized amount

Please type authorized amount!

Date of charge

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Second authorized amount

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Date of charge

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Trip confirmation No.*

Please type your Trip confirmation Number!


I agree:

Please check all the boxes above to complete your transaction!


Please type in your full name - Signature*

Please type in your full name!


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We accept debit or credit.
Credit Card Authorization Form | Colony Limo
1,143,893

Total number of Services

251,181

Total number of customers

782,627

Total number of airport services

14,400

Total number of prom services

Read what people are saying about Colony Limo

 

Colony - Limo Service Houston - Reviews
Colony - Limo Service Houston - Reviews
Colony - Limo Service Houston - Reviews

Call us now at (281) 265-5466