Newport Landing Restaurant and Oyster Bar
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: ______ _______ _______