I hereby authorized The Tacola Resort And Spa   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 :                                                                                     

Card : write down the last 3 digits show on the back of the card :                * (required)

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 Bangkok Office at
(66 2) 276-6599 Attn. MS.Sirikarn E-mail : rsvn@thetacola.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.