Prompt, affordable, professional service

CREDIT CARD AUTHORIZATION FORM
Please print this form and fax information to (340) 776-6734
(after confirming vehicle availability)

Date: ________________

I personally, authorize Courtesy Car/Jeep Rental Inc. to charge a non-refundable deposit in the amount of $100.00 to the following credit card in my name.  I understand that if I need to cancel the car rental I need to give two (2) weeks notice prior to arrival for my charge deposit to be refunded.

_____ Visa              _____ MasterCard                 _____ American Express
Name (as on card)_______________________________________
Account Number  ________________________________________
Expiration Date  ___________________   *CVN# __________
*CVN - 3 digit number on the back of credit card signature panel
Signature  _______________________________________
This deposit will be used towards the rental of a ________________ beginning on ______________ and ending on __________________.
Number in your party  ______
St. Thomas Arrival Time _________ AM / PM  
Flight No. _________
My contact information is:
Name:_______________________________________
Address:_____________________________________
City / State:__________________________ Zip:__________________
Phone:____________________________________
Fax:    _____________________________________
Email Address :    _______________________________________
St. John Local Contact: ___________________________________

P.O. Box 1316, Cruz Bay, St. John, U.S. Virgin Islands 00830
(340) 776-6650 Phone | (340) 776-6734 Fax | (866) 776-4228 Toll Free