Authorization Form

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I, hereby authorize Luxor Limousine Service to debit my credit card in the amount listed below or any amounts pre-approved by me. I understand that execution of this authorization constitutes such approval. I assume full responsibility for any and all non-payments. The cancelation policy** has been fully explained to me and I understand the same. I further understand that the bellow charges may change based on additional stops, parking, tolls, overtime and other miscellaneous expenses.

Full name as it appears on CC *

Email *

Billing Address *

City *

State *

ZIP *

Phone *

Cell Phone *

* Required Fields

Credit Card Number *By submitting payment details you consent to the detection and storage of your IP address to help guard against credit card fraud.

Expiration Date * /

Card Identification Number *For Visa/MasterCard cardholders, this is a 3-digit code on the back of your card, usually printed on the signature strip. For American Express cardholders, this is the 4-digit number printed on the front of your card, usually in small type above your credit card's main number.

Phone number associated with credit card

Date of Ride *

Passenger Name *

Amount to be charged *

I agree to Luxor Limo service terms, conditions and rates *

Authorized signature *

Reset Signature

Date of signature *

Print Name *

Upload jpeg, jpg, gif, png, or tiff scans only.

Front CC scan *

Back CC scan *

ID scan *

Terms & Conditions

Rate and Cancelation/ No-Show Policy
** Cancelation Policy: Luxor Limo Service require minimum (3) hours notice prior to the scheduled pick-up time for Airport Sedan service and 24 hour notice for other services to avoid late cancellation or no-show charges. (prom Cancellation pollicy differs)

NO-SHOW CHARGE: If you not able to locate the chauffeur, please call our 24-hour Customer Service at (718) 998 4111 immediately. One of our customer service representatives will be able to locate our chauffeur right away. NO-SHOW CHARGE will be applied if a passenger fails to call Luxor Limousine Service before leaving the scheduled pick-up location. A NO-SHOW charge will also be applied if the client fails to inform of the cancelation. Cancelation Fee: Late cancellations and NO-SHOW will be charged at a full trip charge.

Airport Transfer Rates: The Airport Transfer rates are based on pick-up and drop-off without any delay or waiting time for Domestic ights. Your reserved vehicle is dispatched according to the ight estimated arrival time provided by the airline-automated system. The rate included 30 minutes airport grace period. Luxor Limo Service is not responsible for delays caused by: Delay or loss of luggage, inaccurate ETA or wrong gate/terminal information, or any unforeseen circumstance. All prices quoted by Luxor Limo Service are for the specic services requested. Any deviation from the requested service by any passenger will result in appropriate additional charges. Luxor Limo Service reserves the rights to assess a minimum fee of $250.00 for any necessary cleaning and/or damage to the vehicle beyond normal wear and tear. Luxor Limo Service is not liable for delay/service interruptions or damages caused by acts of God, strikes, riots, authorities of law, public enemies, hazards or dangers caused by a state of quarantine, perils of navigation, inclement weather, hazardous road conditions, accident or breakdowns or any other condition beyond its control. The undersigned acknowledges and agree that Luxor Limo Service is not responsible for personal property left in the vehicle.