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<br />All Star Events, Inc. <br />16350 NW 15th Ave. <br />Miami, FL 33169 <br />Phone: (305) 623-0058 <br />Fax: (305)623-0067 <br />www.allstar-events.com <br /> <br />INTERNAL USE ONLY: <br />Today's Date: <br /> <br />Sales Rep: <br /> <br />Date Processed: <br /> <br />CREDIT CARD AUTHORIZATION FORM <br /> <br />I, hereby authorize All Star Events, Inc. to charge my Credit card <br />account in the amount: $ <br /> <br />( ) VISA <br /> <br />( ) MASTER CARD <br /> <br />( ) AMERICAN EXPRESS <br /> <br />Credit Card Number: <br /> <br />VID Code: <br />(3 digits) or (4 digits AMEX) <br /> <br />Expiration Date: <br /> <br />/ <br /> <br />Name on Credit Card: <br /> <br />Credit Card Billing Address: <br /> <br />Street: <br /> <br />City: <br /> <br />State: <br /> <br />Zip Code: <br /> <br />Country: (if not U.S.) <br /> <br />Payment for Event: Invoice # <br /> <br />Event Date: <br /> <br />Site Address: <br /> <br />City: <br /> <br />State: <br /> <br />Contact: <br /> <br />Phone Number: <br /> <br />As the credit card holder, I hereby authorize transaction to be charged for the above amount. <br />Please attach a copy of the credit card front and back along with the credit card holder's <br />driver's license. <br /> <br />Card Holder's Signature <br /> <br />Date <br /> <br />Note: By signing the invoice and/or credit card authorization form you agree that All Star Events, <br />Inc. may charge your credit card for balances due if it is not paid in full on the day of event. <br /> <br />*** PLEASE FAX COMPLETED FORM TO (305) 623-0067 *** <br />