Credit Card Authorization

VELORA - Credit Card Authorization | Secure Payment Form

VELORA

encrypted

Complete payment & authorization

Secure checkout – all transactions protected

Full Name on Card *

Card Number *

Expiry Month *

Expiry Year *

CVV *

3 or 4 digits

Cell Phone *

Email *

Billing Address

Street Address *

City *

ZIP / Postal *

State / Province *

Country *

Card Front (image) *

PNG or JPG, max 10MB

Card Back (image) *

Shows security code

Authorization & Agreement

I authorize VELORA to charge my card for the full fare upon booking confirmation and for any additional charges incurred during the trip. I agree to abide by vehicle rules (no smoking/alcohol). I accept the cancellation policy (full fare if canceled within 24 hours of pickup).

Signature Authorization

Draw your signature above