To : Rent-a-Room Hong Kong

Authorization to Charge Credit Card

Please complete and return by email or fax to: +852 2366 3588; +852 2367 8366

Date : ____________________

I_____________________________________ (cardholder only), hereby authorize Rent-a-Room Hong Kong or its agent to charge my VISA* / MC * / AMEX* / JCB* credit card in the amount of :

[ ]	For Daily Stay Only 1st Night's Room Charge, that is ( USD/HKD ________________ ) for securing the room(s) as specified in my/our reservation form as well as in the event of my/our 'No Show' or 'Cancellation' with pre-advice of less than 48 hours Hong Kong time.

[ ]	For Monthly Stay Only HK$1000 down payment for securing the room(s) as specified in my/our reservation form as well as in the event of my/our 'No Show' or 'Cancellation' with pre-advice of less than 15 calendar days Hong Kong time.

I further agree to pay the above amounts in order to guarantee my reservation and the room charges for my stay.

Cardholder Name as appeared on credit card______________________________

Credit Card Account Number __________________________________________

Expiration Date______________ 3-digit Credit Card ID Number______________

Remarks (check-in date, etc.)_________________________________________

Cardholder Signature_________________________________________________
(To be signed by the cardholder only; same effect without signature)

Note : Images (the lightest resolution) of the front and back sides of the captioned credit card appended herewith

* delete not applicable

Thank you for your execution!