PACKAGE#2 with Hotel CREDIT - DEBIT CARD AUTHORIZATION FORM VISA Or MC

“PACKAGE#2 with hotel CREDIT - DEBIT CARD AUTHORIZATION FORM VISA or MC”

I,______hereby authorize San Diego Leisure, to charge on my CREDIT or DEBIT card the amount of $479.00, for (1) APPLICANT service included as follows: 1. (1) Banamex DD visa fee payment done before the applicant arrival 2. One night hotel accommodations in Tijuana, Mexico, next to the U.S. Consulate 3. Trip to Mexico to pay for the DD at Banamex Bank prior appointment NOT on the same day 4. Assistance by a local bilingual agent whom coordinates your consulate trip 5. Assistance in obtaining the new 1-94 in the fastest border on the second day 6. Round trip courtesy shuttle, from SAN DIEGO / CHULA VISTA area in any hotel or garage parking on zip codes; 92101 & 91910 to the U.S. Consulate in TIJUANA, BC, Mexico.

Credit Card Number______Visa____MC____

Expiration date:______Card security code ______

Billing address:______

City______State______

Zip Code______Country______

Appointment date, time and city______

Cell phone #______Email:______

Passport # ______Passport #______

Pick – up & drop off in any Location on Zip Codes; 92101 or 91910, the pick up place can be given one day before appointment by email or phone:

Four hundred seventy nine 00/100+++++++++++++++++++++++++++++++++ ++++++++++++++++++++++++++++ I understand I will be charged US Dollars the sum indicated in the amount line above.

Card Holder Signature______DATE______

Fax it to 619-374-2298 or Email it to: [email protected] Payment: Advance full payment per person is required to secure definite reservation 7 business day’s prior appointment date. San Diego Leisure, Inc will be assisting you with the items 1 to 6, listed above... Cancellation Policy: Partial refund will be guaranteed for all cancellations received 7 or more days prior to appointment date. Cancellations must be in writing; verbal cancellation, whether in person or by phone are not valid. $75.00 processing fee and $75.00 cancellation fee per applicant will apply. If the DD is already paid at the time of cancellation no refunds will be honored due to Banamex bank policy. Trip Postponing Policy: By choosing San Diego Leisure, your money is secure for 365 days from the date the DD is purchased, additional $50.00, will apply every time you reschedule your trip but you will not loss all your funds. Postponing changes are accepted only by email. Note: price and policy is subject to change without notice...