PURE HERBS, LTD.™ DISTRIBUTOR APPLICATION AGREEMENTDistributor Application Agreement • September 5th, 2019
APPLICANTS SOCIAL SECURITY OR FEDERAL EIN NUMBER (FOR TAX PURPOSES ONLY-WE CANNOT PROCESS YOUR APPLICATION WITHOUT THIS INFORMATION)
INTERNAL USE ONLYDistributor Application Agreement • December 31st, 2021
APPLICANTS SOCIAL SECURITY OR FEDERAL EIN NUMBER (FOR TAX PURPOSES ONLY-WE CANNOT PROCESS YOUR APPLICATION WITHOUT THIS INFORMATION)
PURE HERBS, LTD.™ DISTRIBUTOR APPLICATION AGREEMENTDistributor Application Agreement • February 2nd, 2022
APPLICANTS SOCIAL SECURITY OR FEDERAL EIN NUMBER (FOR TAX PURPOSES ONLY-WE CANNOT PROCESS YOUR APPLICATION WITHOUT THIS INFORMATION)
Signature AgreementDistributor Application Agreement • July 4th, 2012 • Utah
By entering my Social Security Number (or Federal Tax Identification Number, if applicable) on this Distributor Application, I certify that this number is my correct taxpayer identification number.
INTERNAL USE ONLYDistributor Application Agreement • May 3rd, 2016
DISTRIBUTOR APPLICATION & AGREEMENT • 分銷商申請表及協議書Distributor Application & Agreement • July 31st, 2018 • Hong Kong
All new distributors are required to purchase a Start Kit at the time of sign-up. The cost of the Start Kit is $500 plus applicable shipping and handling. Prices are in Hong Kong Dollars (HKD). Prices do not include shipping or handling. The distributor can meet the Start Kit requirement either by purchasing the kit by itself or as a component of the optional Vantage Packs shown below.
PURE HERBS, LTD.™ DISTRIBUTOR APPLICATION AGREEMENTDistributor Application Agreement • June 23rd, 2015
ARE YOU AN N.D.? Y / NARE YOU AN IRIDOLOGIST? Y / N EMAIL ADDRESS: IN ORDER TO PROCESS APPLICATION, SIGNATURE OF APPLICANT & TAX INFORMATION IS REQUIRED. SIGNATURE: DATE:
NIKKEN TAIWAN, INC., TAIWAN BRANCHDistributor Application/Agreement • June 17th, 2004
您或您的合夥人/配偶，曾否以個人身份、合夥身份或公司名稱從事過日健事業商?Have you or your partner/spouse ever been a Nikken Distributor indiidually, 有in a partnership, or in a corporation? Yes 否 如有的話，請說明最近之日期：No If yes, please list date of last activity: 月/Month 年/Year 前傳銷商號碼/Period ID. 本人明白，作為日健傳銷商的唯一付費要求，就是按成本價NT$1,600元購買一套日健製作的公司簡介之日健事業指南。本人知道這套日健事業指南並不附有日健產品，而本人成為事業商時有權選擇是否同時購買日健產品。I understand the only financial require, ent to become a Nikken Distributor is the purchase of a NT$1,600 at-cost Sales Kit, which contains sales and demonstration materials and company information produced by NIKKEN. 本人以右列方式購買日健事業指南/Sales Kit一套I am enclosing payment for a sales kit(check one): 信用卡持有人姓名:Cardholder Name: 現金Cash 信用卡號碼:Credit card No.: 有效期至:Expiry date: 信用卡Credit card 年Year 銀行或郵局轉帳．匯款Bank transferr 月Month 持卡人簽名:Cardholder Signature: 支票Check
申請日期/Application Date: 年yy 月mm 日ddDistributor Application & Agreement • December 9th, 2021
INTERNAL USE ONLYDistributor Application Agreement • December 31st, 2021
APPLICANTS SOCIAL SECURITY OR FEDERAL EIN NUMBER (FOR TAX PURPOSES ONLY-WE CANNOT PROCESS YOUR APPLICATION WITHOUT THIS INFORMATION)
DISTRIBUTOR APPLICATION FORMDistributor Application Agreement • September 2nd, 2022
By signing below, I confirm that I have read and agree to the terms and conditions set forth by IMMERI. I verify and affirm that all the above information is accurate and correct to the best of my knowledge. IMMERI reserves the right, at its discretion, to change, modify, add, or remove portions of these Terms at any time by posting the amended Terms. The Company expressly reserves the right to reject any application for any reason that is not prohibited by law.
DISTRIBUTOR APPLICATION & AGREEMENTDistributor Application & Agreement • July 31st, 2018
By checking this box and submitting my personal information, I consent and agree that LifeVantage, its distributors in my Organization/organization or a third party acting for LifeVantage may contact me at my provided email address and/or telephone number and as updated using automated technology such as an auto-dialer or pre-recorded message, text message or email at my cost at my carrier's standard rates for calls and/or texts. I may opt-out from text messages at any time by replying "STOP". I consent and agree that my provided personal information to include my name, addresses, phone and fax numbers, sales data and banking information will be transmitted to LifeVantage and trusted third parties in the United States of America ("USA") to support my LifeVantage account, product orders and their fulfillment. I understand that I may access and rectify my data as well as opt-out of any data transfer to the USA by contacting LifeVantage Compliance at compliance@lifevantage.com. I understa
PURE HERBS, LTD.™ DISTRIBUTOR APPLICATION AGREEMENTDistributor Application Agreement • June 23rd, 2015
ARE YOU AN N.D.? Y / NARE YOU AN IRIDOLOGIST? Y / N EMAIL ADDRESS: IN ORDER TO PROCESS APPLICATION, SIGNATURE OF APPLICANT & TAX INFORMATION IS REQUIRED. SIGNATURE: DATE:
