Thaitel.com 382 N. Lemon Ave. #221 Walnut, CA 91789 Tel. 1800-9992186 Fax. 1866-4224008 Attention: Reseller Department	Date: ____________________
Credit Cardholder's Authorization
In Lieu of my credit card imprint, I, ________________________________________ (Name of cardholder), hereby authorize Thaitel.com to charge my __________________________ (Credit Card Number) - ______________ (Expiration Date) in the amount of USD ______________ for payment of calling cards I order from Thaitel.com for reselling purposes.

My Billing Address:	__________________________________	Phone: (H)___________________
	__________________________________	(O)___________________
	__________________________________
Email Address:	__________________________________
Mailing Address: (if it's different from the billing address)
	__________________________________ __________________________________ __________________________________
Note: Please provide Photostat copy of your Credit Card (Front and Back) and Passport or driver license, together with this authorization form.

	By signing below, I acknowledge charges describe hereon. Payment in full to be made when billing or in extended payments in accordance with standard policy of company issuing card.   X _________________________________________                      (Signature of Cardholder)
Incomplete information or false statement shall be considered sufficient cause for order suspension and cancellation.