I, the undersigned ______________________________ hereby authorize MS Aviation NY and / or any of its suppliers to charge my credit card number ________________________________ Expires ______ /______ CVV _________ for the amount of USD $_______________ for the following reservation, (confirmation code: ______________ if applicable).
Travel Date ________________ Route__________________________ Class ________________ Airline ______________How many passengers ____

Billing address ______________________________________________________ City_____________________ State _______ Zip _________________

Please note: Cardholder identification is required. Please provide a photostat copy of the front and back of the above credit card and one government issued valid picture I.D. such as passport or driver's license.

By signing below, I acknowledge the charges described hereon, and I agree to pay the credit card company the amount mentioned above
for the services rendered in accordance with the standard policy of the issuing Credit Card Company.

I understand these tickets may be: wholly non-refundable or non-changeable or they may be refundable, or changeable only with a penalty.

_______________________                                    _________________________________                                          __________________
(Print Cardholders Name)                                     ( Signature of Card Holder)                                                             Date 

 Kindly fax or email this form to fax +1- 646-448-2771 or email to info@msany.com.

MS Aviation NY | 1960 61st Street | Brooklyn, NY 11204, USA

Tel: 718-682-0444 | Fax: 646-448-2771 | Email: info@msany.com | Website: www.MSANY.com