Credit Card Authorization WINE TASTING DINNER
Event date :___________________ Name of Purchaser(this will be the name of the reservation) _____________________________________________________ Address:_______________ City:__________ Zip:___________________________ Phone:__________________ Fax________________________________________ Number of Guests to be charged to the card (if reservation is to be made for more than this number, another card should be provided to reserve the remaining seats) ________________________________ Tip ($ or %)_______________________ Note: your card will be charged on the day of receipt.
Credit Card Information Type of Credit Card; Visa_____ Master Card_____ Amex_____ Diner’s_____ Discovery_____ Credit Card Number Expiration Date CVV (3 last digits on the back or AMEX 4 digits on the front ) Name as it appears on the credit card:_____________________________________________ Please read and sign credit card authorization below: I hereby authorize Taberna del Alabardero restaurant to charge the designated credit card detailed card above, the full amount of the bill for the party stated above, including any special orders, and sales tax. Furthermore, if card is not valid at the time or the charge is declined, I agree to supply another valid form of payment upon notification. Signed:____________________________ Date:__________________________________________
1776 I street, NW (entrance on 18^th) / Washington D.C. 20006 taberna.dc@alabardero.com / www.alabardero.com Phone (202) 429 2200 Fax (202) 775 3713