Please complete this form and return it to us by fax or mail. Do not submit this form by e-mail. Please include clear, legible photocopies of signature & photo pages of passports for all passengers. 
Fax to: 704-795-5466 
Name of passenger
_______________________________________________________________________
Your name as it appears on your credit card:
______________________________________________________________________
Card Number _____________________________________ Exp Date _____________
Security (CID) Number __________
(Visa, Master Card, Discover CID # is 3-digit on back of card. AMEX CID # is 4-digit on front of card.)
Billing address for this card 
_______________________________________________________________________
_______________________________________________________________________
I authorize Destinations Unlimited Limousines to charge my/our credit card for (circle one):
Deposit      Final Payment            Authorized Amount:___________________

Dates of Transportation ____________________________________________
I understand that my deposit is non-refundable.
Signature: _________________________________________ Date: _______________ 
Phone: _________________________