Isha Travel Management Inc.
Tel : 1-877-FLY-ISHA ; Email : info@ishatravels.com
Fax:(877) -359-4742.

Account Debit Authorization Form

I, ____________________________________ hereby authorize Isha

Travel Management Inc., to debit my account ____________________________________(Account number),

Routing number ____________________,Cheque no_______________on ____________(date)

with_______________________________________________(name of the bank & branch) for

USD_____________(amount) towards the purchase of my air tickets.

I understand that the amount debited is towards the purchase of my air ticket and agree to the terms and conditions listed in our website under "Policies" ЕЕ

Signed__________________________________________ Date:_________________

Address: ______________________________________________________________

City: __________________________________ State:____________ Zip__________

Telephone____________________________Fax: ______________________________

Email:________________________________

Travel Details:

Destination: From ___________ To ____________

Departure Date:_______________

Arrival Date:__________________

Airlines:___________________

***NOTE: Also need a copy of the check used and a copy of driver's license.