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CREDIT
CARD PAYMENT FORM - CASA
PAPAYA RESORT
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I hereby authorized www.asianetonline.com to charge the amount of THAI BAHT . from
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to:
Cardholder's Name : (as it appears on card) Guest's Name : (if different from above) Card Number : Expiry date : Card company : Country: SIGNATURE : _______________________________ Date : _____________________ *********************** IMPORTANT ********************** Please
kindly print this form, fill-in your details and fax it back to our
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