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Get Credit Cardholder's Authorization Form

Dit card) ____________________________ hereby authorize Go To Russia Travel or its agents to charge my: ___ AMEX ___ VISA ___ MASTERCARD $ #__________________________________ Exp. date (mm/yy)__________ in the amount of _____________ Traveler 1: ____________________________________________________Date of birth (mm/dd/yy) _____________ Traveler 2: _____________________________________________________Date of birth (mm/dd/yy) _____________ Traveler 3: _ _____________________________________________.

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