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1cafe100.com

Italian Food ~ Fresh and Fast Daily! Everything Homemade.... Just like Mama used to make! Real Italian Comfort Foods Made from Scratch Daily. Lunch and Dinner ~ 727-204-8762

Cafe 100
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727-204-8762

 

 

 

  

CREDIT AUTHORIZATION FORM

 

Below you will find our credit card authorization form.  Please fill out this form, sign it, then return to us via email (chefbill@1cafe100.com)

or Fax : 1-727-800-5984

 

Thank you,

Chef Bill

Café 100 / All Occasions Catering 

1.     Product or Event:____________________________________

2.     Card Number:_______________________________________

3.     Expiration Date:_____________________________________

4.     Cardholder Name:____________________________________

5.     Cardholders Address:__________________________________

6.     Email Address :_____________________________________

7.     Cardholder Billing Zip Code:___________________________

8.     3 Digit Authorization Code on the back of card:____________

I authorize Café 100 to Charge $_____+ Tip $_____ Total = $_______

USD to the credit card listed above.

Cardholder Signature:_____________________

Today’s Date:_______________

 

The cardholder agrees that Café 6200 will bill the subscriber’s credit card.  Thank you for your cooperation and your continued patronage.

Café 100 / All Occasions Catering

2700 48th ave N

St. Petersburg, FL 33702

727-204-8762