PAYMENT AUTHORIZATION FORM

For your convenience, we will use this authorization form to charge your Visa, Master Card or American Express account. Please fill out this form and fax it to us at: (504) 392-8214

Card Type
Account Number
Expiration Date
Cardholder's Name (please print)
Cardholder's Signature

Cardholder Information (Please provide billing information for the card used.)
Street Address
City
State
Zip
Phone Number
Email

By checking the box below, you agree to the terms of this authorization.

I authorize Avenue Limousine, or one of its affiliate companies, to charge my card for any services rendered to me or on my behalf. I understand I will receive an appoximate quote for these services based on the information I provide when making my reservation, however, any services rendered at the time of the event, which were not initially quoted, will be added to the total amount due and charged to my card. I agree to pay for all services I use and am bound by the terms and conditions of the bank issuing my card. Furthermore, I understand the quote I receive, whether written or verbal, may not include applicable taxes and/or gratuities.