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The $40 I believe is for the membership rewards program. You earn 1 point for every dollar spent. Amex partners include Southwest, Delta, Continental, USAir, TWA, Hawaii Airlines, Mariott, Hilton, Best Western, Starwood, Avis, National, and Budget. This is a good deal if you charge a decent amount on your card and especially if you travel for work.
I do not have any stats on Amex vs Visa/MC acceptance, but you should probably carry both.
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