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STATE OF CALIFORNIA SELLER OF TRAVEL CERTIFICATE REGISTRATION # 2063964-50
STATE OF FLORIDA SELLER OF TRAVEL CERTIFICATE REGISTRATION # T182456
STATE OF WASHINGTON SELLER OF TRAVEL CERTIFICATE REGISTRATION UNIFIED BUSINESS ID # 602232785 BUSINESS # 001 LOCATION 0001
COPY & PASTE THIS AUTHORIZATION FORM INTO YOUR EMAIL ACCOUNT.
CREDIT AND DEBIT CARD AUTHORIZATION INFORMATION

NAME ON CREDIT  CARD _______________________________

EXPIRATION DATE _____/_____ 

CVV _ _ _ 

 ACCOUNT #  XXXX XXXX XXXX _ _ _ _
(COMPLETE ONLY THE LAST FOUR DIGITS.  I'LL CALL TO GET THE OTHERS)

 BILLING ADDRESS:  _____________________________

CITY:___________________________________________

STATE: ________________  ZIP CODE: _______________

EMAIL ADDRESS:  ________________________________

 BILLING PHONE:  _________________________

SIGNATURE x______________________________________
 The above signature, if typed electronically,
is equivalent to a handwritten signature.

PASSENGER 1
NAME:
___________________________                          

FEMALE __ MALE __

DOB
___________________________
 

FULL NAME:
PASSPORT NUMBER:
CITIZENSHIP:
DATE OF ISSUE:
DATE OF EXPIRATION:
 
PLACE OF ISSUE:
PLACE OF RESIDENCY:
PLACE OF BIRTH: 
ISSUING AUTHORITY/
     LOCATION:

NAME & NUMBER OF EMERGENCY CONTACT PERSON NOT TRAVELING WITH YOU: 
ADDRESS_________________________  RELATIONSHIP____________

PASSENGER 2 

NAME ON CREDIT  CARD _______________________________

EXPIRATION DATE _____/_____ 

CVV _ _ _ 
ACCOUNT #  XXXX XXXX XXXX _ _ _ _
(COMPLETE ONLY THE LAST FOUR DIGITS.  I'LL CALL TO GET THE OTHERS)

 BILLING ADDRESS:  _____________________________

CITY:___________________________________________

STATE: ________________  ZIP CODE: _______________

EMAIL ADDRESS:  ________________________________

 BILLING PHONE:  _________________________

SIGNATURE x______________________________________
 The above signature, if typed electronically,
is equivalent to a handwritten signature.             
FEMALE __ MALE __

DOB
___________________________
 

FULL NAME:
PASSPORT NUMBER:
CITIZENSHIP:
DATE OF ISSUE:
DATE OF EXPIRATION:
 
PLACE OF ISSUE:
PLACE OF RESIDENCY:
PLACE OF BIRTH: 
ISSUING AUTHORITY/
     LOCATION:


NAME & NUMBER OF EMERGENCY CONTACT PERSON NOT TRAVELING WITH YOU: 
ADDRESS_________________________  RELATIONSHIP____________

IF CRUISING YOU MUST HAVE:
1. PASSPORT OR #2
2. BIRTH CERTIFICATE & VALID ISSUED GOVERNMENT ID OR DRIVER'S LICENSE.

OPTIONAL:
EMAIL COPIES OF YOUR PASSPORT (MUST BE VALID 6 MONTHS AFTER TRAVEL) AND YOUR BIRTH CERTIFICATE.  ALWAYS HAVE YOUR VALID GOVERNMENT ISSUE PHOTO ID WITH YOU. IF YOU DESIRE YOU CAN ALSO EMAIL A COPY OF YOUR ID.   THIS WAY, JUST IN CASE YOUR ITEMS ARE REQUESTED AND YOU DO NOT HAVE THEM IN YOUR
POSSESSION, I CAN FAX THEM TO THE NECESSARY LOCATION. 

 
FOR A CAR RENTAL WHO WILL THE DRIVER BE?

FULL NAME:_________________________________

PREGNANCY POLICY
https://www.aptatravel.com/3/miscellaneous20.htm

CUSTOMER SERVICE AIR FARE FEES:
DOMESTIC AIR PER PERSON : $25.00
INTERNATIONAL AIR PERSON: $50.00
GROUP RESERVATIONS PER PERSON: $10.00

AIR DISCLOSURE:
I, the travel agent, am not  an airline and I am not responsible for airline maintenance/safety problems; I do not operate aircraft and act only as an agent for identified airline principals that do. 

CUSTOMER SERVICE AIR FARE FEES WAIVED
IF IT'S A PACKAGE DEAL WITH HOTEL THERE IS NO FEE FOR AIR, INTERNATIONALLY OR DOMESTICALLY.

 
TRAVEL GUARD INSURANCE
https://travelguard.com
 
PLEASE, COMPARE THE PLANS AND LET ME KNOW WHICH ONE YOU DESIRE.  I'LL PREPARE THE QUOTE AND GET IT BACK TO YOU.  PAYMENT IS DUE LESS THAN 14 DAYS AFTER YOUR INITIAL TRAVEL DEPOSIT IS MADE. WE ARE NOT ALLOWED TO ADVISE YOU AS TO WHICH PLAN TO PURCHASE.  PLEASE COMPARE THE PLANS, SELECT THE ONE OF INTEREST, SEND YOUR FULL NAMES, DOBs AND ADDRESSES. WE WILL THEN SEND YOU A QUOTE TO REVIEW.  AFTER REVIEWING WE CAN PLACE THAT PURCHASE FOR YOU.  PLEASE SIGN BELOW LETTING US KNOW IF YOU ACCEPT OR DECLINE INSURANCE.    ALSO, CHECK OUT THE ANNUAL PLANS..Business Traveler & TRAVEL RITE ANNUAL PLAN.  

I, _____________________________, ACCEPT THE TRAVEL GUARD INSURANCE.

I, ______________________________, DECLINE THE TRAVEL GUARD INSURANCE.
 The above signature, if typed electronically,
is equivalent to a handwritten signature.

IF ACCEPTED NAMES AND DOBs OF ALL TRAVELERS,
MUST LIVE IN THE SAME HOUSEHOLD.  YOUR NAMES AND DOBs CAN BE SENT BY EMAIL. 

PLEASE READ ABOUT THE OPTIONAL PLANS, THEN CALL ME WITH YOUR DECISION SO I CAN PREPARE YOUR QUOTE.  
https://www.travelguard.com/


Disclaimer FOR ALL ENTRIES ON MY TRAVEL SITE: 
I, Roberta K. Collins, agent with Aquarius Travel Agency, AKA (Always Plan Travel ASAP) reserves the right to correct any errors that may have occurred on this website.

CONTACT INFORMATION:
https://aptatravel.com
aptatravel@gmail.com
702.409.4088