信用卡持卡人授权书 Credit Cardholder's Authorization

信用卡付款仅限美国及加拿大持卡人。付款前请填写并签署本授权书；签署后即可返回购物车，以信用卡完成付款。卡号、有效期与安全码不会在本页输入，只在 Stripe 的安全付款页面输入。

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.

持卡人资料 Cardholder

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

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

Email *

发送验证码 Send code 验证 Verify

✓ Email 已验证 Verified

电话 * Phone number

发送简讯验证码 Send SMS code 验证 Verify

✓ 电话已验证 Verified

信用卡帐单地址 * Credit card billing address (street, city, state/province, ZIP/postal code, country)

卡别 Card brand (选填 optional) VisaMastercardAmerican ExpressDiscoverOther

卡号末四码 Last 4 digits

只填末四码，请勿填写完整卡号 (last 4 only - never the full number)

授权金额 * Amount

US $ CA $

含手续费的预估总额 (estimated total incl. processing fee)

身份证明 Identification

请上传持卡人的护照或驾照照片 (清晰、四角完整)。Please upload a clear photo of the cardholder's passport or driver's licence, all four corners visible.

护照 / 驾照 * Passport or driver's licence

第二页 / 背面 Second page / back (optional)

照片在您的装置上缩小后才上传，仅供本公司核对身份，不会公开。Photos are downscaled on your device before upload, used only to verify identity, and never made public.

授权与同意 Authorization & consent

我在此授权新联华假期 (XO Tours Inc.) 以我的信用卡支付上列金额。我理解这些费用用于支付我和／或我在上面指定的人的旅行费用或机票。

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.

我理解并承认此处描述的费用，并同意于帐单日全额付款，或依发卡机构之协议延期付款。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. 持卡人同意放弃所有拒付 (chargeback) 权利。The cardholder agrees to waive all chargeback rights. 如取消或退款，将收取至少 US$150.00 手续费及航空公司／供应商之费用。我确认上传的身份证件为持卡人本人。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.

签名 Signature

请输入持卡人全名作为电子签名 *
Type the cardholder's full name as your electronic signature

请以手指或滑鼠签名 * Draw your signature 清除 Clear

签署日期 Date: 。提交即表示您同意以电子方式签署本授权书，其效力等同书面签名。By submitting you agree to sign this authorization electronically, with the same effect as a handwritten signature.

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