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Credit Card Authorization Form

American Express, Visa and MasterCard

Hereby I authorize AVENTURA TEQUILERA SA. DE CV. to proceed with


the automatic charge to my credit card of the corresponding debt.

CREDIT CARD INFORMATION:

NAME OF THE BANK: ___________________________________________________________

CREDIT CARD HOLDER _________________________________________________________

CARD NUMBER: ________________________________________________________________

EXPIRATION DATE: _____________________________________________________________

CVV or CVC: ___________________________________________________________________

TOTAL AMOUNT TO BE CHARGED: ______________________________________________

CHARGE AMOUNT IN WORDS: ____________________________________________________

CONCEPT: _____________________________________________________________________

AUTHORIZATION DATE: __________________________________________________________

IT IS HIGHLY IMPORTANT TO ATTACHED A COPY OF BOTH SIDES OF; IDENTIFICATION


AND CREDIT CARD WHEN SENDING THIS AUTHORIZATION LETTER.

INFORMATIVE:
1.- Aventura Tequilera S.A. de C.V. does not have the power to make any additional charges
that are not detailed in this authorization letter.
2. - After submitting the authorization letter, please confirm your credit card account status
and verify that the charge has been completed correctly.
3. – A new authorization letter must be made for each additional charge.

_________________________________
AUTHORIZATION SIGNATURE

COFRADÍA #1297 TEQUILA JALISCO | RESERVE AL: (374) 74 26800 EXT: 100, 102, 132, 204 Y 203
Vigencia 2023

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