信用卡持卡人授權書 Credit Cardholder's Authorization

信用卡付款僅限美國及加拿大持卡人。付款前請填寫並簽署本授權書；簽署後即可返回購物車，以信用卡完成付款。卡號、有效期與安全碼不會在本頁輸入，只在 Stripe 的安全付款頁面輸入。

Credit card payment is available to US and Canadian cardholders only. Please complete and sign this form first; once signed you can return to the cart and pay by card. Your card number, expiry and security code are never entered on this page - only on Stripe's secure payment page.

持卡人資料 Cardholder

持卡人姓名 (與卡片相同) *
Name of cardholder, as on the card

旅客姓名 (若與持卡人不同)
Name of passenger(s) if other than cardholder

Email *

發送驗證碼 Send code 驗證 Verify

✓ Email 已驗證 Verified

電話 * Phone number

發送簡訊驗證碼 Send SMS code 驗證 Verify

✓ 電話已驗證 Verified

信用卡帳單地址 * Credit card billing address (street, city, state/province, ZIP/postal code, country)

卡別 Card brand (選填 optional) VisaMastercardAmerican ExpressDiscoverOther

卡號末四碼 Last 4 digits

只填末四碼，請勿填寫完整卡號 (last 4 only - never the full number)

授權金額 * Amount

US $ CA $

含手續費的預估總額 (estimated total incl. processing fee)

身份證明 Identification

請上傳持卡人的護照或駕照照片 (清晰、四角完整)。Please upload a clear photo of the cardholder's passport or driver's licence, all four corners visible.

護照 / 駕照 * Passport or driver's licence

第二頁 / 背面 Second page / back (optional)

照片在您的裝置上縮小後才上傳，僅供本公司核對身份，不會公開。Photos are downscaled on your device before upload, used only to verify identity, and never made public.

授權與同意 Authorization & consent

我在此授權新聯華假期 (XO Tours Inc.) 以我的信用卡支付上列金額。我理解這些費用用於支付我和／或我在上面指定的人的旅行費用或機票。

I hereby authorize XO Tours Inc. to charge my credit card in the amount listed above. I understand these charges are for the payment of travel expenses or air tickets for me and/or those I designated above.

我理解並承認此處描述的費用，並同意於帳單日全額付款，或依發卡機構之協議延期付款。By signing, I understand and acknowledge the charges described hereon and agree that payment in full is to be made when billed, or in extended payment subject to and in accordance with the agreement governing the use of such card. 持卡人同意放棄所有拒付 (chargeback) 權利。The cardholder agrees to waive all chargeback rights. 如取消或退款，將收取至少 US$150.00 手續費及航空公司／供應商之費用。我確認上傳的身份證件為持卡人本人。In the event of cancellation or refund, a minimum US$150.00 processing fee plus the issuing carrier's charges will apply. I confirm the uploaded ID is the cardholder's own.

簽名 Signature

請輸入持卡人全名作為電子簽名 *
Type the cardholder's full name as your electronic signature

請以手指或滑鼠簽名 * Draw your signature 清除 Clear

簽署日期 Date: 。提交即表示您同意以電子方式簽署本授權書，其效力等同書面簽名。By submitting you agree to sign this authorization electronically, with the same effect as a handwritten signature.

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