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Credit Card Authorization Form
Name on Credit Card:
Address: 
Telephone:
Fax:
Email:
 
I ,
 
 Authorize Luz Tropical S.A., to charge:
US Dollars:
From My:
From My Credit Card Number:
Expiration Date:
I accept all the terms and conditions in the Reservations Policy.
Details / Comments:
Signature:

 

 
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