TOUR PARTICIPANT AGREEMENT

TRAVELSPAN VACATIONS - LOST TICKET REFUND APPLICATION

IN ORDER TO PROCESS LOST TICKET REFUNDS. PLEASE COMPLETE ALL INFORMATION REQUESTED. PLEASE TYPE OR PRINT.

LOST TICKET INFORMATION

IDENTIFICATION	Ticket Number	Passenger Name
COMPLETE ROUTING DESCRIPTION OF TICKET PURCHASED	Origination (From)	Destination (To)
	Was ticket lost or used on this flight?	Airline/Flight/Date
	Origination (From)	Destination (To)
	Was ticket lost or used on this flight?	Airline/Flight/Date

TICKET PURCHASED

Fare Paid ______

Tax Paid ____

Total _____

Where was ticket purchased?

£ Airport Ticket Office

£ City Ticket Office

£ Travel Agency

Name and address of purchase location

What was the method of payment?

£Check £ Air Travel Plan

£Cash £Credit Card

£ Government

Account Name

Account Number

REFUND/REPLACEMENT INFORMATION

REFUND INFORMATION £Pay Refund £Credit Account	Name /Address
	Account Name/ Number
REPLACEMENT INFORMATION	Ticket Number	Origination (From)	Destination (to)
	Place/Date Issued	Flight Number/Date	Cost
PERSONNEL USE ONLY	No Charge Must be authorized by signature TRAVELSPAN agent below. Use only if the “lost” ticket was pulled in error during check in for a previous flight and has been so verified. (Attach a complete form to the Auditor’s coupon of the issued replacement ticket.)

MISCELLANEOUS

LOST TICKET

NUMBER AND/OR

COPY TICKET

SUGGESTIONS

1) If purchased from a Travel agency, contact that office for a copy of the ticket number.

3. II paid by credit card, the ticket number appears on the charge form.

2. If paid by check, the ticket number (13 digits) should appear on the

cancelled check.

4. Note to travel agents: II you are submitting this form on behalf of

your customer, please send a copy of your agent’s coupon with the

lost application.

THE UNDERSIGNED UNDERSTANDS AND AGREES THAT:

1. In consideration of the payment of the refund or the issue of replacement ticket without charge, the undersigned will reimburse TRVAVELSPAN for loss or damage it may sustain because of the use of the unused portion for transportation or refund.

2. Refund will not be processed unless the complete number of the lost ticket is entered, or sufficient information is given to enable TRAVELSPAN to definitely establish the ticket number.

3. Claims for the lost ticket refunds must be made not later than one month after the expiration date of the lost ticket.

4. TRAVELSPAN is not responsible for tickets presented for transportation or refund by other than the true owner and assumes no responsibility for determining identity.

5. Upon finding the lost ticket, the applicant will immediately send the ticket to TRAVELSPAN along with the statement that a lost ticket application was previously filed.

6. A service charge of $100.00 per ticket will be imposed for handling the refund of a lost ticket. The service charge will be deducted from the refund where processed. This charge is subject to change without notice.

……………………………………………………………. ……………………………………………………

PASSENGER (S) NAME WITNESS

IDENTIFICATION

SUGGESTIONS

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