HerbalifeInternationalPhilippines,Inc.

GroundFloor,GoodlandBuilding 377GilPuyatAvenue,MakatiCity Tel:(632)8973450Fax:(632)8995005/3254725

Credit Card ONE-TIME Authorization Form

DearHerbalifesDistributor, We are pleased to inform you that our credit card facility is available for your convenience. If you wish to utilize this facility, please fill in the Credit Card AuthorizationFormatthebottomandreturntoourDistributorServicesDepartmentforprocessing. YouareallowedtoregisterandutilizeuptoTHREE(3)creditcardsforyourpurchasesfromHerbalifeInternationalPhilippines,Inc.Kindlyfurnishusthedetails ofyourcreditcardswhichyouwillbeutilizingtopurchaseproductsasbelow. Later, if you decide to use a different credit card other than those stated as below, kindly submit a separated authorization form/letter to our Distributor ServicesDepartmentforverificationandupdate. Note: i)Pleaseattachedaphotocopyofyourcreditcards(bothside)ANDatleastonevalidIDforverificationpurposes ii)Distributorsarenotallowedtousethirdpartycreditcards.Thisissolelyforyourpersonaltransactionsonly.

Credit Card Holders Information:

Name: __________________________________________________________________________ ID Number : _____________________ Tel : _____________________

Address: __________________________________________________________________________________________

Card Holders Name 1) 2) 3)

Credit Card No

CVC

Issuing Bank

Expiry Date

IherebyauthorizeHerbalifeInternationalPhilippines,Inc.tochargemycreditcardaccount(s)forpurchasesImadeviaphonein,email,faxin,walkinandSMS orderundermyID(IndependentDistributor)Number.Moreso,purchasesmadeonmybehalf.Likewise,IagreeontheTerms&Conditionsstatedbelow.

_____________________________________ Signature of Card Holder

_________________________________ Date

Terms&ConditionsforCreditCardAuthorization:
1. 2. HerbalifeInternationalPhils.,Inc.isundernoobligationtohonoranycreditcarddebtinstructionunlessthereissufficientavailablecreditlimitinthe CreditCardaccountatthetimeofprocessingtheorders.Thedistributormustensurealwaysthatthereissufficientfundbeforeplacingtheirorders. HerbalifeInternationalPhils.,Inc.shallnotberesponsibleforanyclaimonloss,damage,costsandexpensesarisingfromtheunsuccessfulprocessing oftheordersorremittanceforanyreasonwhatsoever,includingbutnotlimitedtononavailabilityoffunds,malfunctionofsystem,electricityfailure, inaccurateorinsufficientinformationbeingsuppliedbytheapplicant.Assuch,volumeforthisorderwillnotbecounted,unlesssuccessfully processed. HerbalifeInternationalPhils.,Inc.reservestherighttochargethecreditcardtheactualamountasreflectedinthesystem.Distributorisheld responsibleforanydiscrepancywhicharisesduetowrongcalculationoftheirorder(s).Likewise,HerbalifereservestherighttochangetheTerms andConditionsanddeterminethearrangementsfortheserviceprovidedhereunderatitsdiscretionwithoutassigninganyreasons. TheapplicantagreesthatHerbalifeInternationalPhilippines,Inc.shallbeentitledtoimposechargesasdeemedappropriateforprovidingtheservice mentionedhereunderwithpriornoticetotheapplicant. HerbalifeInternationalPhils.,Inc.mayatanytimeandfromtimetotimewithoutpriornoticewithdrawfromprovidingtheservicementioned hereunderatanytimewithoutassigninganyreasonsandshallnotbeheldliableforanylossordamagewhichmaybesufferedbytheapplicantasa resultofsuchactionbyHerbalife. ThesigningofthisagreementservesasanauthorizationforHerbalifeInternationalPhilippines,Inc.touseandchargethecreditcard(s)mentioned aboveforeverysingletransaction.Hence,thisisaONETIMEauthorizationforallthecardholderstransactions.Thelatteragreedaswellthatno verificationandsignatureofthechargeslipisrequired.Thisremainsinforceunlessrevokebyapplicantinwriting. ThesignedauthorizationformandacopyoftheofficialreceiptshallconstituteproofthatthetransactionandthechargesmadebyHerbalifetothe creditcardisvalid;assuch,theDistributorwillnotrequestthebankorcreditcardcompanytoremovethesaidcharge(s).

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