I hereby authorized www.asianetonline.com  to charge the amount of

THAI BAHT                                                                   

from __                                ___ to:                                             

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

Guest's Name :                                                                             (if different from above)

Card Number :                                                                                     

Master / VISA - the last 3 digits show on the back of the card :______________

AMEX - 4 digits code :                                  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 Attn. Miss Varin E-mail :rsvn@asianetonline.com
Remarks : The charge will be exercised only in case of No-Show or cancellation less then 48 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.