Personal Account
Credit Card Charge Authorization Form

In order for us to process your request, please print, fill out and fax the following authorization to us at 201.385.6191:

I, (Cardholder name*)_________________________________________________________

Authorize A & I Transportation, Inc. to charge all expenses to my credit card *number

#______________________________________________________*Exp._______/________

*Billing address______________________________________________________________

*City________________________________ *State________________ *Zip code_________

*Home phone___________________________________ Cell phone__________________

Fax number______________________________________ E-mail_____________________

I understand that these charges may include, but are not limited to, all tolls, parking, waiting time, stops, NO SHOW, LATE CANCELLATIONS, etc. If I can't find my driver, I understand that it's my responsibility to call A & I Transportation. Failure to call our office to leave pickup-location will result in No-Show charge to my credit card. I agree that if I wish to cancel my reservation it is my responsibility to notify A & I Transportation at least two (2) hours before reservation time. Failure to do so will result in LATE CANCELLATION charges to my credit card.

*Cardholder Signature___________________________ Date:________/_______/_______

Please attach a clear and readable photocopy of both sides of your credit card to this form.

Thank you for choosing A & I Transportation, Inc.