I hereby authorized   to charge the PHUPHAYA RESORT ,PATTAYA

to charge my credit card for the accommodations

Date check in:                                      check out :                                                  

Total Amouth in THAI BAHT :                                                                                     

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 Rervation Office at
+66 0 2945-8922 Attn: Khun Anna E-mail :booking@phuphayaresort.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.