I here by authorized AMARI BOULEVARD, BANGKOK   to charge the

amount of USD $                                                                                 

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 :               

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(not included peak season)
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.