I use a US Amazon account on my Kindle abroad. Yes, they did originally charge an extra $1.99 to download a book directly to your Kindle over 3G. This has changed in the last few months though - Amazon no longer charges the extra $1.99 to download a book over 3G.
Here's a snippet from the new Kindle 3 User's Guide:
"U. S. Customers Traveling Outside The U. S.
For U. S. customers traveling outside the United States, there is no additional charge to have your books, periodical subscriptions, and personal documents delivered to your Kindle if you connect to Whispernet using Wi-Fi.
For Kindle models that include 3G, books and single issues of periodicals will be delivered via 3G at no additional cost, but 3G delivery of personal documents will be charged per megabyte. Delivery of periodical subscriptions via 3G is available if you sign up for the International Subscription Service. This service offers the convenience of 3G delivery for a weekly fee. When you travel outside the U. S., Amazon automatically sends a notice to your Kindle Home screen with instructions on how to sign up for the International Subscription Service. If you don’t choose to sign up for this service, your periodicals will be delivered at no additional charge only when you are connected to Whispernet using Wi-Fi. Alternatively, you can download your periodicals to your computer and then transfer them to your Kindle via USB."
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