Credit Card Authorization
503 E. Edgewater Ave., Newport Beach, Calif. 92661
Phone: (949) 675-2373 Fax: (949) 675-0682

I hereby authorize the Newport Landing Restaurant in Newport Beach, California to charge my credit card for Banquet or Restaurant related charges.

Banquet Client Name: _________________________

Banquet Date: _________________

Description of Payment: ________________________

Cardholder Name: _____________________________

Cardholder Billing Address: ____________________
______________________________________________
______________________________________________
Business Ph: ( ) _________ Home Ph: ( ) __________

Method of Payment

Visa Mastercard Amex Discover

Credit Card Number: ____________________________
Expiration: _________ In the Amount of: __________
Cardholder Signature: __________________________
Print: _________________________
Auth Date: ____________________