203 612 2821, 203 595 5333


In Lieu of My Credit Card Imprint, I Hereby Authorize Mypayanam/or partner payment gateway to charge an Amount totaling USD . My American Express / Visa / Master Credit Card No CVV: Expiry .
Credit Card 24 hour Card member Service Tel. #: For Transportation for Myself and/or .

*Relationship: (W: Wife - D/S: Daughter/Son - P: Parent - O: Other please state

1. (M/F) Date of Birth: *Relationship:
2. (M/F) Date of Birth: *Relationship:
3. (M/F) Date of Birth: *Relationship:
4. (M/F) Date of Birth: *Relationship:
5. (M/F) Date of Birth: *Relationship:

For the Following Routing Onward city: Return city:
I understand that the tickets to be issued may have; restrictions, be non-refundable/refundable, change fees and penalties.

Please double check your itinerary for traveler(s) name spellings. This document is not for name check on travelers name in itinerary and corrections.For any name change fare subjected to change (based on seat availability). Mypayanam is not responsible for baggage allowance,seat assignment, bassinet, wheel chair, frequent flyer program,meal preference or transit/travel visa requirement.

My Billing Address for the Credit Card used is:
Street: City/State: Zip:
Home Phone: Business Phone: Fax: E-mail:
I will support this authorization with scanned copies of my credit card (front and back) and a federal ID such as a valid driver's license.

By signing below, I acknowledge full liability for the charge described payment in full will be made when billed in accordance with standard policy of bank issuing the card.Also by signing I accept the terms and conditions

E-mail or Fax this from back to your sales agent @203 595 5333 or

SIGNATURE: _________________________________     DATE: _______________

All Form must be received before 5 PM EST for ticketing and no exception(s)
Fare Quoted Subject to Change without notice and Mypayanam not responsible for any fare change


Terms and conditions

1. Please reconfirm your flights with the airline 24 hours prior to each travel date.
2. All information related to passenger are kept confidential and secure.
3. Prices are only guaranteed if booked and purchased on the same day.
4. Ticket and fare are valid only as issued. Some tickets are non-refundable and non-changeable. If allowed, fees/penalty will apply for any changes.
5. All changes must be made 36 hours prior to your schedule departure.
6. If Passenger(s) are unable to travel, you must call Mypayanam 36 hours prior to your scheduled departure and cancel your flights.
7. Involuntary schedule changes or flight cancellation initiated by the airline are not the responsibility of Mypayanam though we will try our best to re-accommodate.
8. Be advised that penalties apply for changes and refunds. Check with your Mypayanam consultant before purchasing your tickets.
9. Penalties are from $375+* to non-refundable per ticket.
10. Change for return is allowed for a penalty from USD $249+*/ticket and up depending upon the airline.
11. Credit card fees are additional depending upon airline.
12. No refund on partially used tickets.
13. Ticket will have no refund/reissue value if you "NO-SHOW" for any of your flights.
14. Mypayanam not responsible for seat assignment, wheel chair, bassinet, frequent flyer numbers, meal preferences.
15. Please confirm with airline about the baggage allowance & restriction.
16. Parental consent letter for kids (infant/child) visiting India while traveling with one parent.
17. Passengers are responsible for verifying that their Passport is valid 6 (six) months beyond the scheduled return date, as well as any Visa requirements for each destination.
18. Check operating carrier website for any policies that may vary.
19. If there a dispute/charge back on charge amount additional $75/- charged as penalty.
20. Most tickets are e-tickets and will be issued as e-tickets whenever possible. If tickets have to be issued as paper tickets, there will be an additional shipping chargers to ship via FedEx/UPS/DHL.

For any assistance please CALL 203 595 5333 OFFICE HOURS 24/7.
All ticket bound by the terms and condition listed on