Credit Card Authorization

(This HTML version is for viewing only. Please PRINT this PDF, fill out and submit to your catering contact. )


Today’s Date: ____/____/_____
Contract Number: _______________________________
I, ______________________________(Card Holders Name), hereby authorize Kelber Catering, Inc.
to charge my credit card account for ___________________________________________(Name of Event),
on ___________________________ (Date(s)), for payment of food and beverage,
up to a maximum charge of $____________________________(amount not to exceed $10,000.00).
Credit Card Number: ____________________________________________________
Expiration Date: _____________  CV2: ________
(3 digit number on back of Visa, MC, Discover) (4 digit on front of Amex)
Type of Card: ___ Visa ___ Mastercard ___ Discover ___ American Express
Credit Card Billing Address:
_______________________________________________________________________________
City: _________________________________________________________________________
State: ________ Zip Code: ___________________
Name as Appears on Card: _____________________________________________________
Card Holder’s Signature: ____________________________________________________
__I authorize Kelber Catering to use the credit card number above for payment. (Initial)__________.

Catering Contact: (check one) __Lisa Anderson __Heidi Hudson __Stephanie Case __Nick Gundlach


For office use only

PAYMENT INFORMATION

Amount of Transaction:

 Amount of Transaction:

Date of Transaction:

   Date of Transaction:

Sale Approved Code:

   Sale Approved Code:

Done by:    Done by:

Rev. 2/2020