INDEPENDENT BUSINESS OWNER (IBO) Inscription Accord Please enter the ID number IBO if you pre-registered online at www.amway.com or by phone (800) 253-6500. IBO IDENTIFICATION NUMBER. PLEASE IMPRIMER USING BLACK INK. SPONSORING IBO INFORMATION SPONSORING IBO ID NO. LAST NAME FIRST NAME Country International Sponsor ID no | | | | | | | | | | | | International sponsor | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |-| | |-| | | | CO-REGISTRANT`S LAST NAME (if applicable) CO-REGISTRANT`S FIRST NAME (if applicable) CO-REGISTRANT`S SOCIAL SECURITY NO. | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |-| | |-| | | | STREET ADDRESS DAYTIME TELEPHONE NUMBER – | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | If the sponsor resides outside the United States, Canada, Puerto Rico, U.S. Virgin Islands, Jamaica, Guam, Pacific Islands American Samoa, Federated States of Micronesia, Marshall Islands, Northern Mariana Islands, Palau, Wake Island, Dominican Republic or other authorized Atlantic and Caribbean islands that are under the Amway Independent Compensation Plan for Business Owners for North America (“Plan”), or, if the registrant has a major activity in another country, complete the information below: REGISTRANT (S) INFORMATIONS LAST NAME FIRST NAME SOCIAL SECURITY NO. | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |-| | | |-| | | | City State Zip Code EVENING TELEPHONE NUMBER (optional) | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |-| | | |-| | | | E-Mail ADDRESS | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | Social Security number – If the principal filer does not provide a social security number, a percentage of all bonuses are retained. Email Address – For order confirmations, product updates and special offers, it is important that Amway have a unique email address for each IBO. Amway will not pass this information on to unrelated third parties or send unwanted emails. Has any of the filers ever been linked to Amway? Yes No If “Yes,” please indicate the date of the last activity: months Previous Year ID No.
What is your preferred language to choose communications when available? English Spanish Korean Mandarin Russian Amway Business Services – Support – $50.00 IBOAI Assistance (see back for information) $12.00 Product Kit (including shipping) $95.74 SUBTOTAL (if applicable) – TOTAL The optional welcome product kit helps you start your business by introducing some of the best-selling products. Business and assistance fees will be refunded in full within 90 days Amway payment received. Payment method (select only one) | | | | | | | | | | | | | | | | | | | | | | | | | | | | – | | | (Please enter or print) CARDHOLDER`S NAME CARDHOLDER`S SIGNATURE CARD NUMBER INVOICE NO. Cash Check/Money Order (joint) Discover ® MasterCard ® Visa ® American Express ® Diners Club ® EXPIRATION DATE (mm – yy) X AUTHORISATION AND AGREEMENT (REGISTRANT (S) MUS READ AND SIGN) AGREEMENT TO MEDIATE AND ARBITRATE DISPUTES – Amway