EFTA00604408.pdf

rjETSUITE Phone +1 866 779 7770 Email: Company: Quote Number: 9233720 Contact: Jeffrey Epstein Date Quoted: 03/17/16 Address: Phone: Fax: Email: Trip Dates: 03/17/16 to 03/17/16 Aircraft: Tail It: Learjet 55 LEG DATE ETD DEPARTURE CITY ARRIVAL CITY PAX ETA NM EFT 1 03/17/16 08:00 PM BEDFORD, MA. (KBED) TETERBORO. NJ. (KTEB) 6 08:50 PM 158 0:50 158 0:50 Flight cost Tax 1 @ $7.050.00/trip $7.050.00 @ 7.50% $7,050.00 $528.75 Total $7,578.75 Amenities Oven, Pets allowed, Freon air conditioning, Enclosed lavatory, Other phone, CD player, Satellite phone, Leather seats, Full galley S A. • • • r rn-fr-c rnLtI,QT SIGNATURE DATE Reference #9233720 JetSuite Page 1 of 2 EFTA00604408 rjETSUITE PAYMENT AUTHORIZATION FORM PLEASE SELECT OPTION t OR 2' 'A credit card must be authorized for all trips, including trips paid by wire transfer. JetSuite Phone: +1 866 779 7770 Fax +1 562 683 2664 Ena Websirte: t) CREDIT CARD I authorize JetSuite to charge the aerie card listed below in the amount agreed upon for air charier services and understand the credit card will be charged a iS L .precessing fee. excluding FET. Charges will be charged to the credit card immediately. Any additional charges payable hereunder including without limitation for catering. international fees. ground transportation. flight phone usage. overnight hangar expense. and deicing will be charged upon completion of trip to the credit card. Any charges incurred by JetSuite at a later date. will be charged to the credit card when incurred. Customer Initial Date 2) WIRE TRANSFER Funds must be received four (4) business days before the scheduled departure. If funds are not received by such deadline. I authorize JetSuite to charge the credit card listed below in the amount agreed upon for air charter services. Charges will be charged to the credit card immediateN. Any additional charges payable hereunder including without limitation for catering. international fees. ground transportation. fright phone usage. overnight hangar expense. and deicing will be charged upon completion of tdp to the credit card set forth below. Any charges incurred by JetSuite at a later date. will be charged to the credit card when incurred. I authorize JetSuite to charge such credit card for such additional fees. Customer Initial Date PAYMENT BY WIRE: MAILING ADDRESS: Wells Fargo Bank JetSuite CREDIT CARD: VISA MASTERCARD AMERICAN EXPRESS DISCOVER NAME ON CARD: CREDIT CARD NUMBER: EXPIRATION DATE; SECURITY CODE; BILLING ADDRESS: CITY. STATE. ZIP; COUNTRY: 'The pewided awe cad with* used 1w at Mow autwimdwn. AVICAIIXOS. incidents mates rtqlleSted WEI& deantsoepakr QUOTE ACCEPTANCE: Please sign. date. and return to JetSuite. Your signature indicates your acceptance of the above terms and conditions. Signature Date Reference #9233720 JetSuite Page 2 of 2 EFTA00604409