Payment
order to:
RS TRANS ASIA Co., Ltd.
HO: 998/6(4) BA, Baan Onnut-Condominium,
Onnut 30-32 Sukhumvit 77 SuanLuang Bangkok
10250.
Tel: +66-2-7420139-40, Fax: +66-2-3325707
Branch: Unit 1A, Ground Floor, 29 Vanissa
Bldg., Soi Chidlom, Ploenchit Rd.,Lumpini,
Patumwan, Bangkok 10330 Tel: +66-2-7420139-40, Fax: +66-2-6551257
Type of Card: [___] VISA [___] MASTER [___]
AMEX
Payment
for___________________________________________________________________
Name
as it appears on card :_____________________________________________________
Address
:_____________________________________________________________________
City
/ State: ___________________________Country: ________________________________
Tel
:__________________________ Fax:___________________________________________
Email
Address :_______________________________________________________________
Passport
Number /Nationality :_________________________________Expire_____________
Card number : [___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|___|
Expiration
Date : ______________________
Amount
Authorized to deduct : ___________________
Total
in letter: ________________________________________________
Signature as on cards : ___________________________
Date
: ___________________________
We truly appreciate your support and are looking
forward to providing you with our great services.
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