PIYADA RESIDENCE - PATTAYA
390 /23 M.10 Pattaya 3Rd., South Pattaya, Pattaya,Chonburi,THAILAND 20150
Tel : (66) 038 - 713316 Fax : (66) 038 - 713309 E-mail : rsvn@piyadapattaya.com


E-mail address :rsvn@piyadapattaya.com Web site www.piyadapattaya.com
 Credit Card Payment Fax Form

To guarantee your booking, please printout this form, fill it out completely all the information and fax to our reservation fax line Thailand : +66 3871 3309 Currently we accept only VISA MASTER or JCB

Guarantee Amount Requisition
Payment by VISA/ Master Card / JCB
I authorize PIYADA RESIDENCE to take the details of the credit card indicated below as a guarantee.
Card type:--- [   ] VISA ---- [   ] Master   [   ] JCB
Card Number  
Card Number  
Card Holder's Name  
Card Country  
Guest's Name  
Guest's Name  
Amount in THAI BAHT  
Card Holder’s Signature

Policy for reservation / cancellation
• Guaranteed reservation can only be made through this reservation form
• Cancellations and/or changes should be made in writing to us before your state arrival date: Daily reservation at least 3 days; Monthly reservation at least one week.
• Terms of cancellation will be shown on the hotel confirmation.
• All extra expenses and the total amount of the invoice have to be paid for before check-out.
********************* FOR OFFICAL USE ONLY *******************
Approval Code  
Authorizer  
Date of Approval  

************************************* IMPORTANT *************************************
The charge will be exercised only in case of No-Show or cancellation less then 3 days before arrival for daily rate and. If guests check-in, this charge will be cancelled and guests have to pay in full amount at the reception upon arrival.