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Shuka's Credit Card Form
38 MacDougal St, New York, NY 10012
Phone: 212-475-7500
Email:
info@shukanewyork.com
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* Indicates required question
Email
*
Your email
Phone Number
Your answer
Name on the card
*
Your answer
Card Number
*
Your answer
Expiration Date
*
MM
/
DD
/
YYYY
CCV
*
Your answer
Billing Address
*
Your answer
Reservation First Name
*
Your answer
Reservation Last Name
*
Your answer
Reservation Time
*
Time
:
AM
PM
Reservation Date
*
MM
/
DD
/
YYYY
Purchase Items
*
Your answer
Gratuity
*
15%
18%
20%
N/A
Other:
Additional Notes (messages)
Your answer
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