Credit Card Authorization
- Print Credit Card Authorization
- Please print, complete, and fax to 714-257-9420
Please Check Appropriate Item:
- ( ) Banquet Deposit
- ( ) Gift Card Purchase
- ( ) Merchandise Purchase
- ( ) Prearranged Reservation Payment
Today's Date: __________________
Date of Event: ____________________________________
Time: ___________
Group Name / Contact: ______________________________
Name of Cardholder: ___________________________________
Billing Address: ___________________________________________
City / State: __________________________________
Zip Code: _______________
Phone Number: ______________________
Fax Number: ______________________
Type of Card: _________________________
Expiration: ______________________
Account Number: _______________________________________
I, ___________________________________________ (Print Name of the Card Holder) hereby authorize TAPS Fish House & Brewery to charge my account in the amount of $___________________________________ for the following service(s):
Please check the appropriate item:
- ( ) Banquet Deposit
- ( ) Gift Card Purchase
- ( ) Merchandise Purchase
- ( ) Prearranged Reservation Payment.
If using this form for a Banquet Deposit the amount specified above will be applied to the balance due the day of the event. Please note this will not be a refund to your credit card, but rather a payment toward the final bill.
Signature of Cardholder _____________________________________________
Date _________________________
**Please attach copy of front and back of card to this document