Wedding Receptions at The Plantation House Restaurant Credit Card Form ~ 2008

Credit Card Authorization All invoices are due in accordance with contract terms. After 30 days, if payment is not received, the credit card will be charged. Please print, fill out and fax or mail this form to The Plantation House Restaurant (info at bottom of this page). If you have any questions, contact The Plantation House by telephone at 808-669-6299 or by sending e-mail to info@theplantationhouse.com before faxing or mailing completed form. Please do not supply credit card number or cardholder information via e-mail. Name(s) event is booked under: ______________________________________     Date of event: _________________ (mm/dd/yy)         Time of event: _____________ Home phone number: _____________________        Local Maui phone number: ________________ I irrevocably authorize my credit card to be used for services at The Plantation House Restaurant, Maui, Hawaii Comments:_________________________________________________________________ ___________________________________________________________________________

Credit card type: _________________________________________________ Credit card number: ______________________________________________ 3-digit (MC/VISA) or 4-digit (AMEX) credit card security number: ________ Located on front of card on AMEX or back of card in signature box on MC/VISA Expiration date: ___________________________ Cardholder: ____________________________________________________ Print name exactly as it appears on card Billing address: _________________________________________________ City, state, zip: _________________________________________________ Signature: __________________________________________________ I warrant and represent that I am authorized to agree that charges for this event are posted to this credit card.

The Plantation House Restaurant 2000 Plantation Club Dr Kapalua, HI 96761 Tel.   808-669-6299 Fax   808-669-1222 e-mail   info@theplantationhouse.com Return to weddings main page.