Boston Limousine and Logan Airport limo service

170 Tremont Street Boston MA 02111

Call Us: (617)-209-1009

Boston Limo
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Credit Card Authorization Form

I,, authorize Bos Town cars to charge the following credit card for the transportation services on the date of

I understand that the amount stated on the confirmation will be the minimum amount that can be charged and I also understand that the amount chard will be the amount of actual charges shown on the trip confirmation(s). It is also understood that if the prepayment is not received prior to the date of the service, then my card will be charged automatically for the whole amount stated on the trip confirmation. I understand that reservation(s) listed below is (are) not refundable and may not be canceled.

Customer name:*

Company Name:

Phone Number:*

Fax number:

Card Holder:*

Statement Address:*

Last 4 digits of Credit Card number:*

Experation Date:*

Email Address:*

Card Holder Date of Birth:*

Today's Date:*

Reservation Number: