I here by authorized AMARI ANGKHANG NATURE, CHIANGMAI   to charge

the amount of US $                                                                                 

to my credit card for the accommodations from __                     to:                         

Cardholder's Name :                                                      (as it appears on card)

Guest's Name :                                                          (if different from above)

Card Number :                                                                                    

Master Card : write down the last 3 digits show on the back of the card :               

AMEX : please inform Billing address                                                                        

Expiry date :                                   Card company :                                      

Country:                                               

SIGNATURE : _______________________________ Date : _____________________

*********************** IMPORTANT **********************

Please kindly print this form, fill-in your details and fax it back to our Bangkok Office at
(66 2) 541-9574 Att. Miss Varin E-mail :rsvn@asianetonline.com
Remarks : The charge will be exercised only in case of No-Show or cancellation less then 72 hours
before arrival. If guests come to stay in the hotel, this charge will be cancelled and guests have to pay
in full amount at the hotel.