IMPORTANT MAILING INFORMATION

IMPORTANT MAILING INFORMATION
Mail Value Coupon To:
Northwest Airlines WorldVacations
P.O. Box 5040
Minot, ND 58702-5040
USA
Passenger Name(s)
NAME OF PASSENGER/NOM DU PASSAGER
Type of package
MISCELLANEOUS CHARGES ORDER
BON POUR SERVICES DIVERS
(NOT TRANSFERABLE/INCESSIBLE)
EXCHANGE COUPON No. 1
COUPON D’ ECHANGE N o 1
SMITH / JOHN
SUBJECT OF TERMS AND CONDITIONS ON BACK OF PASSENGER
COUPON/SOUMIS AUX CONDITIONS FIGURANT AU DOS DU COUPON PASSAGER
DATE OF ISSUE/DATE D’EMISSION
TYPE OF SERVICE FOR WHICH ISSUED/TYPE DE SERVICE
US dollar amount in
letters/USD/US dollar
amount in figures
Issued to
Booking Number
NORTHWEST AIRLINES WORLDVACATIONS KAGE
VALUE FOR
EXCHANGE
POUR UNE
VALEUR DE
1
AMOUNT IN LETTERS/MONTANT EN LETTRES
CURRENCY/ AMOUNT IN FIGURES/MONTANT EN CHIFFRES
MONNAIE
Nine hundred and twenty 00/100
USD
TO/POUR
920.00
AT A
N O RTHWEST AIRLINES WORLDVA C ATIONS
RESERVATION
DATA
RESERVATIONS
REMARKS/OBSERVATIONS
MINOT
5 0 3 7 569 04 4
BANKERS RATE/TAUX BANCARE
.64
EQUIV. AMT. PAID/CONTRE-VALEUR VERSEE
1436.36 CAD
TAX ON MCO/TAXE SOR MCO
OTHER CHARGES/AUTRES FRAIS
TOTAL
PLACE OF ISSUE - AGENCY
LIEU D’EMISSION - AGENCE
1436.36 CAD
NON-REFUNDABLE
FORM OF PAYMENT/MODE DE PAIEMENT
CHECK
Form of Payment
ISSUED BY/EMIS PAR
143.63
VOID IF MUTILATED OR ALTERED. VALID ONE YEAR
FROM DATE OF ISSUE./ NUL SI MUTTLE OU MODIFIE.
VALABLE UN AN A COMPTER DE LA DATE D’EMISSION
92.00
CPN/COUPON
AIRLINE/CIE AER
FORM
SERIAL NUMBER/No DU BILLET
ISSUED IN EXCHANGE FOR
EMIS EN ECHANGE DE
ORIGINAL ISSUE
PREMIER EMISSION
Canadian dollar
amount valid on
date of booking
ISSUED IN CONNECTION WITH/BILLETS COMPLEMENTAIRES N os
ENDORSEMENTS/RESTRICTIONS (CARBON)/ENDOS/RESTRICTIONS (CARBONE)
BOOKING NO. 123456
THUNDER BAY TO LAS VEGAS
3 NTS
IMPERIAL PA L A C E
Special Remarks
Canadian dollar
amount valid on
date of booking
Rate of
Exchange on
date of booking
AIRLINE/DEALER
CIE-AER
FORM
SERIAL NUMBER/No DU BILLET
*CAD Commission Amount
PALCE/LIEU
DATE
AGENT’S NUMERIC CODE
CODE NUMERIQUE DE L AGENCE
*USD Commission Amount
*Note: To assure accurate deduction of your commission, please rewrite
amount on the value coupon that is mailed to WorldVacations.
DO NOT MARK OR WRITE IN THE WHITE AREA ABOVE/NE RIEN INSCRIRE DANS LA PARTIE BLANCHE CI-DESSUS
Validate on
Northwest plate
CK/CONTROLE