Credit card Deposit Payment

CREDIT CARD FAX FORM
To guarantee your booking, please printout this form, fill it out completely all the information
and fax to our reservations fax line Thailand : at (66 2) 541-9574
In case of no show, one night charge will be cherged through your credit card.
Currently we accept Only Visa, Master Amex or JCB cards.

I hereby authorized _______________________________________ to charge the amount of

_______________________________________________

Period from ________________________ To ________________________

Guests name : _______________________________________________

Card Holder Name : _______________________________________________

Card company : ___________________________ Country: ___________________________

Card Number : _____________________________________________________

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

AMEX - 4 digits code : ___________________________

Expiry date : ___________________________

SIGNATURE : ___________________________ Date : ___________________________

*********************** IMPORTANT **********************
Please kindly print this form, fill-in your details and fax it back to our Bangkok Office
at (662) 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.