RETURN THIS COMPLETED FORM TO AMWAY TO FINALIZE YOUR IBO REGISTRATION. Pre-registered IBOs If you have already been assigned your IBO ID number either online at www. amway. com or by phone at 800-253-6500 you are temporarily authorized to act as an IBO for 90 days subject to the Rules of Conduct. IBOs a channel of communication with Amway on key issues affecting the business. The annual fee is included in your registration and renewal fees. I need only select the Business Services Support portion of the Amway Registration Package to become an IBO. Retain a copy for your records. PARENT OR GUARDIAN SIGNATURE Required if Registrant s is under 18. IBO Registration Agreement PAGE 1 OF 2 NN 100113 LA-1037-Z AMWAY TERMS AND CONDITIONS 1. By executing the IBO Registration Agreement Agreement you apply for legal authorization to become an Amway IBO and enter into a contract with Amway Corp. Amway. Your contract with Amway includes all of the terms in this Agreement any renewal form s executed or authorized by you the Plan as defined in Rule 2. You will receive IRS Form 1099-MISC reflecting the amount of income paid to you during the calendar year by Amway your sponsoring IBO or your Platinum IBO. It will be your sole responsibility to account for such income on your individual income tax returns. If you do not wish to support the IBOAI you may send a refund request within 90 days of registration or renewal to Customer Service 58C-2A 7575 Fulton Street East Ada MI 49355 and Amway will issue a check or credit to refund the annual fee. INDEPENDENT BUSINESS OWNER IBO Registration Agreement Please enter assigned IBO ID number if pre-registered online at www. amway. com or by phone 800 253-6500. IBO ID NO. INVOICE NO. PLEASE PRINT USING BLACK INK. SPONSORING IBO INFORMATION LAST NAME FIRST NAME If Sponsor resides outside the U*S* Canada Puerto Rico U*S* Virgin Islands Jamaica Guam the Pacific Islands of American Samoa Federated States of Micronesia Marshall Islands Northern Mariana Islands Palau Wake Island Dominican Republic or other authorized Atlantic and Caribbean islands operating under the Amway Independent Business Owner Compensation Plan for North This is my Primary Business. America Plan OR if Registrant has a primary business in another country complete the information below Country International Sponsor ID No* REGISTRANT S INFORMATION CO-REGISTRANT S LAST NAME if applicable SOCIAL SECURITY NO. STREET ADDRESS STATE - DAYTIME TELEPHONE NUMBER CITY ZIP CODE EVENING TELEPHONE NUMBER optional E-MAIL ADDRESS Social Security Number - Failure of the primary registrant to provide a Social Security Number will result in withholding a percentage of all bonus payments. Email Address - To receive order confirmations product updates and special offers it is important that Amway has a unique email address for every IBO. Amway will not share this information with any non-affiliated third parties or send any unwanted emails. 00 12. 00 95. 74 Cashier s Check/Money Order enclosed Discover MasterCard Visa American Express Diners Club CARD NUMBER SUBTOTAL Sales Tax as applicable TOTAL The optional Welcome Product Kit helps jump start your business by introducing you to some of the top selling products.
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