Independent Afliate Application

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Afliate Information:
Enrollment Option: Payment Method:
Applicant's Social Security Number (Required for commission checks to be issued)
Phone Number Fax Number
GanoLife ID# (To be issued by GanoLife
TM
Employee)
AIIuLe's IrsL Nume (BusIness numes noL permILLed InILIuIIy) M.I.
AIIuLe's usL Nume (BusIness numes noL permILLed InILIuIIy)
BIIIIng Address: SLreeL Number und NumeJP.O. Box (US OnIy)
SIIppIng Address: (OnIy II dIerenL Irom ubove. MusL be un ucLuuI uddress wILIIn ConLInenLuI US, AK or H)
ApL.JSuILe #
ApL.JSuILe #
CILy
CILy
State
State
ZIp Code
ZIp Code
Email Address
* If the shipping address is in an unincorporated zone, please attach a copy of your Sales Tax information to this application.
X3 Pack (500 PV/BV) $995.00
X2 Pack (250 PV/BV) $495.00
X1 Pack (100 PV/BV) $195.00
Genesis Plus $100.00+
Genesis Pack $63.00
Aliute Bosiness Kit $25.00
Credit Card Number
Cardholder Printed Name (As It Appears on Card)
Cardholder's Billing Address State Zip Code
Cardholder Signature
Applicant Signature Date
Co-Applicant Signature Date
Exp. Date (MM/YY) CVV2 (See back for details)
Cash Check Money Order
Credit Card: VISA MasterCard AmEx Discover
Check or Money Orders are held for
validation before request is processed
Send to Shipping Address Above
WILL CALL PICKUP at 935 S. Milliken Ave., Ontario CA 91761
( PIeuse SeIecL OnIy One )
Enrollment options
and prices shown do
not include shipping
and handling.
Real-time shipping
charges may apply.
Applicable sales tax
will apply based on
location. Enrollment
form for Continental
US, AK or HI
residences only.
Shipping Selection: ( PIeuse SeIecL OnIy One )
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Afliate Co-Applicant Information: (WIII you purLner wILI someone In doIng your GanoLife
TM
business?)
Enroller Information: (The person that introduced you to GanoLife
TM
.)
Placement Information: (WIere do you wunL Lo be pIuced In LIe bInury Lree?)
Co-AppIIcunL's SocIuI SecurILy Number
Co-AppIIcunL's IrsL Nume (BusIness numes noL permILLed InILIuIIy) M.I.
First Name
First Name
Co-AppIIcunL's usL Nume (BusIness numes noL permILLed InILIuIIy)
Enroller's ID#
Sponsor (Placement) ID#
Last Name
Last Name
LeIt Side or Right Side
( Required: an Independent Afliate must be 18 yrs or older OR
have a legal guardian sign on their behalf as a co-applicant)
Total Amount of Purchase (shipping & tax may be added)
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Independent Aliute Applicution Iorm | pg 1 of 2
GunoLiIe
q S. MIIIIken Ave., #B
OnLurIo, CA q1;61
www.gunoIIIe.com
Qoestions:
(qoq) ;86-oqo
M- Irom 8um-pm
8
By signing below, I acknowledge that I have carefully read all of the Terms and Conditions on both sides of this application.
I understand the Terms and Conditions contained herewith and agree to be bound by them. I also understand that I may
terminate my Independent Afliate status at any time with written notice to Gano Life.
1840143751 Raul Duenez
By submILLIng LIIs ndependenL GunoIIe AIIuLe AgreemenL Ior consIderuLIon:
1. undersLund und ugree LIuL GunoIIe PoIIcIes und Procedures consLILuLes purL oI LIIs
ndependenL AIIuLe AppIIcuLIon AgreemenL und, wIen uccepLed by GunoIIe, LIey,
LogeLIer wILI LIe GunoIIe CompensuLIon PIun und uny oLIer documenL IncorporuLed
by reIerence, Iorm LIe AgreemenL beLween me, us un ndependenL AIIuLe, und
GanoLife.
2. cerLIIy LIuL um uL IeusL 18 (or `m enroIIIng wILI u IeguI guurdIun us u co-uppIIcunL)
yeurs oI uge und undersLund LIuL LIIs AgreemenL Is noL bIndIng unLII receIved und
uccepLed by GunoIIe, In uccordunce wILI LIe GunoIIe PoIIcIes und Procedures.
3. undersLund wIII become un ndependenL AIIuLe (IndependenL conLrucLor) oI
GunoIIe onIy upon uccepLunce oI LIIs uppIIcuLIon by GunoIIe. As un AIIuLe,
wIII Iuve permIssIon Lo seII uuLIorIzed producLs und servIces In uccordunce wILI LIe
uuLIorIzed GunoIIe CompensuLIon PIun.
q. ucknowIedge LIuL, us un AIIuLe, um noL purcIusIng u IruncIIse or excIusIve
dIsLrIbuLorsIIp, und no Iees ure requIred Irom me Ior LIe rIgIL Lo dIsLrIbuLe GunoIIe`s
products.
5. wIII, us un AIIuLe, ubIde by uII Iuws, ruIes, und reguIuLIons enucLed by uny governIng
uuLIorILy perLuInIng Lo LIIs AgreemenL und LIe ucquIsILIon, receIpL, IoIdIng, seIIIng,
dIsLrIbuLIon, or udverLIsIng oI GunoIIe`s producLs, IncIudIng uny IIcensIng or reporLIng
requirements.
6. wIII, us un AIIuLe, esLubIIsI und servIce my cusLomers, be responsIbIe Ior my own
busIness, und ucknowIedge LIuL um noL un empIoyee oI GunoIIe und LIuL our
uIIuLIon Is neILIer subjecL Lo nor governed by uny empIoymenL Iuws, provIsIons, Luxes
or wILIIoIdIngs In LIe UnILed SLuLes oI AmerIcu.
;. cerLIIy LIuL wIII operuLe my busIness In uccordunce wILI uII LIe ruIes und reguIuLIons
seL IorLI by GunoIIe PoIIcIes und Procedures, und uny IuLure umendmenLs,
suppIemenLs, or repIucemenLs.
8. undersLund LIuL LIIs AgreemenL muy noL be LrunsIerred or ussIgned wILIouL wrILLen
consent from GanoLife.
9. ugree Lo, uL my own expense, muke, execuLe, or hIe uny reporLs und be soIeIy
responsible for declaration and payment of all taxes that may accrue because of my
IndependenL busIness ucLIvILIes In connecLIon wILI LIIs AgreemenL.
1o. undersLund LIuL, Ior Income reporLIng purposes, GunoIIe Is requIred by IederuI
Iuw Lo usk Ior my SocIuI SecurILy Number. Under ILs rIgIL oI conLrucL, GunoIIe wIII
noL Issue me commIssIons eurned II cunnoL, or wIII noL, provIde LIIs number und IL
cun be verIhed correcL. GunoIIe wIII LermInuLe my uIIuLIon ImmedIuLeIy, wILIIoId
uny commIssIons due me, und reporL LIe muLLer Lo LIe upproprIuLe uuLIorILIes II LIe
number provIde proves InvuIId.
11. ucknowIedge LIuL GunoIIe wIII reporL uII commIssIons, rebuLes, und bonuses eurn,
equuI Lo or greuLer LIun $ 6oo, Lo LIe nLernuI Revenue ServIce (RS).
1z. cerLIIy, under penuILIes oI perjury, LIuL:
A. TIe SocIuI SecurILy Number sIown on LIIs Iorm Is my correcL Luxpuyer IdenLIhcuLIon
number;
B. um noL subjecL Lo buckup wILIIoIdIng becuuse: (u) um exempL Irom buckup
wILIIoIdIng, or (B.) Iuve noL been noLIhed by LIe nLernuI Revenue ServIce (RS)
LIuL um subjecL Lo buckup wILIIoIdIng us u resuIL oI u IuIIure Lo reporL uII InLeresL
or dIvIdends, or (C.) LIe RS Ius noLIhed me LIuL um no Ionger subjecL Lo buck up
wILIIoIdIng, und
C. um u U.S. person (IncIudIng u U.S. resIdenL uIIen)
1. reuIIze LIuL LIe nLernuI Revenue ServIce does noL requIre my consenL Lo uny provIsIon
oI LIIs documenL oLIer LIun LIe cerLIhcuLIons requIred Lo uvoId buck up wILIIoIdIng.
1q. undersLund LIuL LIIs AgreemenL sIuII uuLomuLIcuIIy renew unnuuIIy provIded LIuL
Iuve muInLuIned ucLIve sLuLus us un AIIuLe by generuLIng u mInImum oI o PV (poInL
vuIue) durIng u perIod oI sIx (6) consecuLIve monLIs.
1. undersLund LIuL uII rIgILs Lo bonuses, rebuLes, und commIssIons, my GunoIIe
busIness, und LIe opporLunILy Lo purcIuse producLs Irom GunoIIe sIuII ImmedIuLeIy
be subjecL Lo cunceIIuLIon sIouId my sLuLus become InucLIve. undersLund LIuL um
IneIIgIbIe Lo recIuIm uny orgunIzuLIon or suIes voIume IosL due Lo InucLIvILy (us ouLIIned
In pubIIsIed GunoIIe murkeLIng progrumJcompensuLIon pIun.
16. undersLund LIuL um enLILIed Lo cunceI purLIcIpuLIon In LIe GunoIIe murkeLIng
progrum uL uny LIme und Ior uny reuson upon wrILLen noLIce Lo GunoIIe. oIIowIng
noLIhcuLIon oI cunceIIuLIon or LermInuLIon, LIe sponsorIng AIIuLe, or GunoIIe wIII
repurcIuse InvenLory und In uccordunce wILI GunoIIe PoIIcIes und Procedures.
1;. cerLIIy LIuL neILIer GunoIIe nor my sponsor Ius mude uny cIuIms oI guurunLeed
eurnIngs or represenLuLIons oI unLIcIpuLed eurnIngs LIuL mIgIL resuIL Irom my eorLs.
undersLund LIuL muy noL muke uny verbuI or wrILLen sLuLemenLs regurdIng cIuIms oI
Income or poLenLIuI eurnIngs LIuL mIgIL resuIL Irom my eorLs or LIe eorLs oI oLIers.
18. ugree Lo LruIn LIe AIIuLes sponsor und provIde bonu hde supervIsory ussIsLunce Lo
supporL LIe suIe und dIsLrIbuLIon oI producL Lo end consumers. ExumpIes oI bonu hde
supervIsIon IncIude, buL ure noL IImILed Lo, wrILLen correspondence, personuI meeLIngs,
LeIepIone conLucL, voIce muII, eIecLronIc muII, personuI LruInIngs, compuny LruInIngs,
und oLIer ucLIvILIes LIuL supporL producL suIes und dIsLrIbuLIon. I usked, wIII be ubIe
Lo provIde evIdence Lo LIe compuny, semIunnuuIIy, oI my ongoIng IuIhIImenL oI LIese
responsibilities.
1q. undersLund LIuL GunoIIe`s progrum Is buIIL upon reLuII suIes und personuI
consumpLIon. um enLILIed Lo purcIuse producL Ior my own personuI or IumIIy use,
und undersLund LIuL GunoIIe poIIcy proIIbILs LIe purcIuse oI producL or Iurge
quunLILIes oI InvenLory soIeIy Ior LIe purpose oI quuIIIyIng Ior bonuses or udvuncemenL
In LIe compensuLIon progrum. IkewIse, wIII noL encouruge oLIers In LIe progrum
Lo purcIuse excessIve InvenLory Lo quuIIIy Ior bonus, overrIdes, undJor udvuncemenLs.
20. undersLund LIuL no uLLorney generuI or oLIer reguIuLory uuLIorILy revIews, endorses,
or upproves uny producL, uIIuLIon, compensuLIon progrum, or compuny und LIuL cun
muke no sucI cIuIms Lo oLIers. n LIe evenL u quesLIon urIses concernIng GunoIIe`s
reguIuLory or IeguI sLuLus, sucI quesLIons sIuII be submILLed Lo GunoIIe In wrILIng.
z1. undersLund LIuL, on u perIodIc busIs, GunoIIe muy suppIy conhdenLIuI InIormuLIon
In LIe Iorm oI geneuIogIes, reporLs, und oLIer sensILIve muLerIuI, wIIcI wIII provIde
me, us un ndependenL AIIuLe, wILI InIormuLIon concernIng my orgunIzuLIon. ugree
upon receIpL oI suId InIormuLIon, LIuL sucI InIormuLIon Is proprIeLury und conhdenLIuI,
und wIII noL dIscIose sucI InIormuLIon Lo uny LIIrd purLy, eILIer dIrecLIy or IndIrecLIy,
nor wIII use LIe InIormuLIon Lo compeLe wILI GunoIIe eILIer dIrecLIy or IndIrecLIy.
22. ugree Lo IndemnIIy und Lo IoId GunoIIe bIumeIess Irom uny und uII cIuIms, dumuges,
und expenses, IncIudIng uLLorney Iees, urIsIng ouL oI my ucLIons und conducL In
vIoIuLIon oI LIIs AgreemenL.
23. undersLund und ugree LIuL uII cIuIms und dIspuLes reIuLIng Lo LIIs AgreemenL, LIe
rIgILs und obIIguLIons oI LIe purLIes, or uny oLIer cIuIms or cuuses oI ucLIon reIuLIng Lo
LIe perIormunce oI eILIer purLy under LIIs AgreemenL, undJor purcIuse oI producLs or
servIces, sIuII be seLLIed LoLuIIy und hnuIIy by urbILruLIon In LIe CILy oI OnLurIo, SLuLe
oI CuIIIornIu, In uccordunce wILI LIe ederuI ArbILruLIon AcL und LIe CommercIuI
Rules of the American Arbitration Association. Each party to the arbitration shall be
responsIbIe Ior ILs own cosLs und expenses oI urbILruLIon, IncIudIng IeguI und hIIng Iees.
zq. ucknowIedge LIuL my purLIcIpuLIon In LIe GunoIIe IexOrderJIxOrder PIun Is
sLrIcLIy voIunLury. IexOrderJIxOrder orders ure processed on scIeduIed IexOrderJ
IxOrderJIxOrder duys (1sL, LI, 1oLI, 1LI, zoLI & zLI oI eucI monLI). GunoIIe
wIII process & sIIp uII IexOrderJIxOrder orders wILIIn one (1) busIness duy oI
LIe seIecLed duy oI LIe monLI. I you seIecL u sLurL duy more LIun z8 duys Irom your
orIgInuI order you muy noL be AcLIve Ior u perIod unLII your IexOrderJIxOrder
order Is processed. New IexOrderJIxOrder orders musL be receIved by GunoIIe uL
IeusL hve () busIness duys beIore LIe specIhed duy. An AIIuLe muy cIoose Lo swILcI
IexOrderJIxOrder duLes uL uny LIme. WIen IexOrderJIxOrder duLes IuII on u
SuLurduy, Sunduy or HoIIduy LIe order wIII be processed on LIe cIosesL busIness duy
(after or prior to the scheduled date).
ndependenL GunoIIe AIIuLe AppIIcuLIon AgreemenL
Terms und CondILIons (See www.gunoliIe.com[policy Ior compIeLe PoIIcIes & Procedures)
CVV2 NUMBER
The CVV2 is an important security feature for credit card transactions on the Internet and over the telephone. CVV stands for Card Verication Value.
t Visa, MasterCard and Discover Cards - The CVV2 is the three-digit number printed in the
signature space on the back of most credit cards. It is always the last group of numbers in the
signature space on the back of the card. It is not part of your regular credit card number.
tAmerican Express - The CVV2 is a four-digit number located on the front, above the embossed
credit card number. It is printed (at) and not part of the embossed number.
Independent Aliute Applicution Iorm | pg 2 of 2