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| MEASUREMENT GENTLEMAN | MEASUREMENT LADIES |

TONY’S FASHION HOUSE LETTER FOR PAYMENT
I WOULD LIKE TO ORDER THE GERMENTS FROME YOU PLEASE
PROCEED WITH THE ORDER AND MAIL THEMR TO ME.

I AUTHORIZE YOU TO WITHDRAW BAHT :
FROME MY CREDIT CARD DETAILS AS GIVEN BELOW.
CREDIT CARD
CREDIT CARD NO :
EXPIRY DATE :
NAME OF BANK :
AMOUNT TO WITHDRAW :
PASSPORT NO :
BIRTHDAY :
FULL NAME OF CARD :
SINGNATURE :
ADDRESS :
TELEPHONE NO :
FAX NO :

IF THE CREDIT CARD IS VESA / MASTER CARD PLEASE WRITE THE THREE DIGITS ON THE LAST BACK SIDE OF THE CARD

IF THE CREDIT CARD IS AMERICAN EXPRESS PLEASE WRITE THE THREE DIGITS ON THE LAST BACK SIDE OF THE CARD

IF THE CREDIT CARD IS DINERD CLUB PLEASE WRITE THE THREE DIGITS ON THE LAST BACK SIDE OF THE CARD