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Form preview Herbalife order form John Smith Independent Distributor 123 West Any Street Your Town CA 90502 t 123 456 7890 / f 123 446 7890 Invoice Date Invoice Name Ship To Phone Fax Email Address SKU Description Qty Unit Retail Price Notes Your Total Price Your Price Customer Loyalty Program Subtotal Tax Please Send Payment To Shipping Handling Total Due I understand that this order may be considered as an invitation to call upon me from time to time with the understanding that I will be under no obligation to buy. Important Notice You the buyer may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. See the Notice of Cancellation on the reverse of this form for an explanation of this right. After the three-day cancellation period provided above you are still protected by the HERBALIFE REFUND POLICY as set forth. John Smith Independent Distributor 123 West Any Street Your Town CA 90502 t 123 456 7890 / f 123 446 7890 Invoice Date Invoice Name Ship To Phone Fax Email Address SKU Description Qty Unit Retail Price Notes Your Total Price Your Price Customer Loyalty Program Subtotal Tax Please Send Payment To Shipping Handling Total Due I understand that this order may be considered as an invitation to call upon me from time to time with the understanding that I will be under no obligation to buy. Important Notice You the buyer may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction* See the Notice of Cancellation on the reverse of this form for an explanation of this right. After the three-day cancellation period provided above you are still protected by the HERBALIFE REFUND POLICY as set forth. Page 1 of 2 Herbalife Refund Policy Herbalife offers an exchange or a full refund. Simply request a refund from your Distributor within thirty 30 days from receipt of your product and return the unused portion with the product containers to the Distributor named on the front side. Notice of Cancellation Date of Transaction / / You may CANCEL this transaction without any penalty or obligation within THREE 3 BUSINESS DAYS from the above date. If you cancel any property traded in any payments made by you under the contract or sale and any negotiable instrument executed by you will be returned within TEN 10 BUSINESS DAYS following the receipt of the seller of your cancellation notice and any security interest arising out of the transaction will be cancelled* If you cancel you must make the goods available to the seller at your residence in substantially as good condition as when received any goods delivered to you under this contract or sale or you may if you wish comply with the instructions of the seller regarding the return shipment of the goods at the seller s expense and risk. If you do make the goods available to the seller and the seller does not pick them up within twenty 20 days of the date of your Notice of Cancellation you may retain or dispose of the goods without any further obligation* If you fail to make the goods available to the seller or if you agree to return the goods to the seller and fail to do so then you remain liable for performance of all obligations under the contract.

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