EFTA00296817.pdf

HeIiNY.com Helicopter Flight Services, Inc. CREDIT CARD AUTHORIZATION FORM Date July 31, 2013 Number of Pages 2 To: Mr. Jeffrey Epstein From: Riptinder Singh Co: Helico • ter Fli. ht Services, Inc. Email: Email: Phone: Phone: Fax: Fax: Reservation Number: 196028 Date of Flight: July 31, 2013 Day of flight: Wednesday Number of Passengers: 2 Time of Flight: 3:00pm Flight Description: E34th Street Heliport (6N5) Long Island Mac Arthur Airport (ISP) 4 Wait 45min 4 E34th Street Heliport (6N5) Cancellation Policy: • Refunds will not be given if HFS receives less than 4 hours notice of a cancelled flight. • 20% cancellation fee for the flights cancelled more than 4hrs but less than 24hrs. • Refunds are not given if you do not call to cancel your flight or do not show up for your flight. • Discounts/Refunds will not be honored once the flight is completed. • HFS will notify the passengers as soon as possible, if there is a weather cancellation. • $300 per hour charge (Pro rated) for any wait beyond the scheduled departure time. • $250 early/late operation heliport fee applies if the flight lands/departs NYC heliports: a. Before 7:00am Mon-Fri & 11:00am Sat-Sun. b. After 7:00pm Mon-Sun. • $200 early/late pilot fee applies if the pilot departs/returns its base (LDJ): c. Before 8:30am Mon-Sun. d. After 7:00pm Mon-Sun. alr• • Cancellation charges will be charged to the credit card # provided. _a g 144e r Please complete, sign and return by fax the Credit Card Authorization Form alon (front & back) of your credit card. Helicopter Flight Services, Inc. Downtown Manhattan Heliport Pier 6 and the East River New York, NY 10004 Phone: , Fax: Email: EFTA00296817  Sir HeIiNY.com Helicopter Flight Services, Inc. CREDIT CARD AUTHORIZATION FORM I hereby authorize HELICOPTER FLIGHT SERVICES, INC. to execute charges to the following card: Credit Card Type Name as it appears on the card Credit Card Number Security ID on Card Expiration Date Billing Address of Credit Card: Please complete, sign and return by fax the Credit Card Authorization Form along with a copy (front & back) of your credit card. Accepted Charge: $2,820.00 Reservation Number: 196028 I understand that all charges made upon this authorization shall be known to me in advance & I accept the above mentioned amount for the Helicopter Charter Flight. e"..fit H".1.41 437ei br Signature Helicopter Flight Services, Inc. `fir Downtown Manhattan Heliport Pier 6 and the East River New York, NY 10004 Phone: , Fax: Email: EFTA00296818