TOKYO RENTAL INTERNATIONAL RESERVATION FORM.
PLEASE RETURN VIA FAX NO. (+81) 03-5652-7056
NOTE: For identification purposes, please also fax a copy of your passport.
Name:              
Gender:       Date of Birth:      
Nationality:     Passport no.:  
Home Address:          
               
Home Tel:       Fax no.:      
E-mail:       Mobile no.:      
Occupation:   Company:  
Company Address:            
               
Company Tel:              
Type of Visa:       Expiration Date:      
Please circle the appropriate type of room you would like to reserve, and calculate your total charge, incl.
1st month's rent + utility fee and the deposit. Next month's rent will be due 1 month after your move-in date.
  Private Room: Shared Room:  
1 month-stay JPY 61,000 JPY 31,000  
6 month-stay JPY 60,000 JPY 30,000  
12 month-stay JPY 59,000 JPY 29,000  
       
Utility+Internet Fee: JPY 9,000 JPY 9,000  
Refundable Deposit: JPY 29,000 JPY 29,000  
       
TOTAL CHARGE:        
Move-in Date:     Move-out Date:      
Credit Card Type:   VISA     MasterCard     JCB Credit Card no.:      
Expiration Date:      (month/year)        
I,                                                             , hereby state that all of the information above is accurate.
I would like to reserve the above-circled type of accommodation from                        to                    (m/d/y).
I,                                                             , hereby authorize Tokyo Rental, to charge my credit card the
amount of                                 JPY and understand that once this reservation has been confirmed, these
funds are 100% non-refundable and my reservation may NOT, under any circumstances, be cancelled.
   
   
                                                                                                                                                          
                                            Signature                                                      Date