Amway India Enterprises Pvt. Ltd. DISTRIBUTOR ORDER FORM Amway India Enterprises Pvt. Ltd.

Regd. Office: Plot No. 5, DDA Shopping Centre, Ground & First Floor, Elegance Tower
Okhla Commercial Complex, Phase II, New Delhi - 110 020. “Updated as on 28-05-2010” Plot No.-8, Heirarchical Commercial Centre, Jasola
DISTRIBUTOR NUMBER : New Delhi - 110 025 We're listening

DISTRIBUTOR NAME :
PUC HD Location : Date :

SKU NO. Qty. Description PV DAP Total SKU NO. Qty. Description PV DAP Total
Value Value
236691ID LITERATURE KIT-ENGLISH 0.00 995.00 212739 IDG DYNAMITE AFTER SHAVE MOIS. 100 ML 2.13 133.00
236754 ID LITERATURE KIT-HINDI 0.00 995.00 212740 IDG DYNAMITE AFTER SHAVE SPLASH 100 ML 4.40 275.00
9788 IDA NUMBERLESS. APPLICATION PAD 0.00 100.00 214087 IDG PERSONA PREMIUM 3 IN 1 75 Gms 1.47 93.00
230293 IDF PERSONA SENIOR TOOTHBRUSH (4 IN 1) 1.52 92.00
230294 ID PERSONA JUNIOR TOOTHBRUSH (4 IN 1) 1.16 72.00
215434 ID SAT. ADVANCED 2 IN 1 SACHET 4 MLX20 1.40 100.00
215435 ID SAT. ADVANCED DC SACHET 4 MLX20 1.40 100.00
NUTRITION & WELLNESS 215436 ID SAT. DETANGLER SACHET 4 MLX20 1.40 100.00
89 IDL NUT. BONE HEALTH WITH IPV - 60 Tabs 29.37 1833.00 100660 IDG G&H BODY SHAMPOO 60 ML 1.55 96.00
102992 IDG NUT. CONC. FRUITS & VEG. LM 20.67 1291.00 200760 IDG GLISTER MULTI-ACTION TP 100 Gms (PASTE) 1.67 104.00
5985 IDG SIBERIAN GINSENG 100 Tabs 35.36 2208.00 100950 IDG SWEETSHOT MINT 8 ML (MOUTH FRESHENER) 2.53 158.00
8086 IDG GLUCOSAMINE HCL 120 Tabs 35.36 2208.00 100661 IDG G&H LOTION 60 ML 1.55 96.00
100066 IDL NUTRILITE SALMON OMEGA 60 Tab 16.00 999.00
100076 IDG NUT.GARLIC HEART CARE LM 60 Tab 8.27 516.00
100082 IDG NUT. KIDS CHOC. DRINK 500 Gms 12.00 749.00
109780 IDG NUT. KIDS DRINK MANGO 12.00 749.00
103902 IDG NUT. KIDS BANANA DRINK 500 Gms 12.00 749.00 COSMETICS
107766 IDG NUT. PROTEIN FAMILY PK 1 KG 39.11 2441.00 A4871 IDL LOOSE POWDER - FAIR 20.11 1249.00
100141 IDG NUT. PROTEIN POWDER 500 Gms 23.09 1441.00 A4872 IDL LOOSE POWDER - MEDIUM 20.11 1249.00
100142 IDG NUT. PROTEIN POWDER 200 Gms 10.95 683.00 104126 IDL ESS HYDRATIN CLEANSER (Pink) 14.74 916.00
100260 IDG NUTRILITE DAILY LM 60 Tabs 15.35 958.00 104127 IDL ESS HYDRATIN TONER (Pink) 14.74 916.00
100309 IDF TRIPLE GUARD ECHINACEA.60 Tabs 18.11 1125.00 104128 IDL ESS HYDRATIN LOTION (Pink) 17.41 1083.00
100863 IDG NUTRILITE KIDS CHEWABLE 60 Tabs 14.67 916.00 104129 IDL ESS BALANCING CLEANSER (GREEN) 14.74 916.00
100997 IDG NUTRILITE IRON FOLIC 90 Tabs 9.75 608.00 104130 IDL ESS BALANCING TONER (GREEN) 14.74 916.00
101153 IDG NUTRILITE BIO C 100 Tabs 14.67 916.00 104131 IDL ESS BALANCING LOTION (GREEN) 17.41 1083.00
101154 IDG NUT. PARSELENIUM E 30 Tabs 14.67 916.00 107992 IDL ALPHA HYDROXY SERUM PLUS 29.49 1833.00
101419 IDG NUTRILITE NATURAL B 100 Tabs 10.00 624.00 100183 ID5 ARTISTRY CREAMY MASSAGE 20.09 1249.00
102745 IDG NUT. DAILY 120 Tabs 26.02 1624.00 106399 IDL POLISHING SCRUB -A8 ESS 14.74 916.00
105074 IDG NUTRILITE FIBER 11.07 691.00 106401 IDL MOISTURE INTENSE MASQUE 14.74 916.00
100070 IDA NUTRILITE CH BALANCE 34.85 2166.00 105531 IDL REPLENISHING EYE CREME 9.38 583.00
212132 IDF POSITRIM LOW FAT DRINK (CHOC.) 22.78 1416.00 100240 IDL SKIN REFINISHING LOTION 29.49 1833.00
217040 IDG POSITRIM LOW FAT DRINK (VANILA) 23.36 1458.00 104020 ID2 PURE WHITE ESSENCE 26.80 1666.00
101821 IDL TIME DEFIANCE DAY TIME CREME 29.49 1833.00
101822 IDL TIME DEFIANCE DAY TIME LOTION 29.49 1833.00
101823 IDL TIME DEFIANCE NIGHT TIME CREME 29.49 1833.00
101824 IDL TIME DEFIANCE NIGHT TIME LOTION 29.49 1833.00
103077 IDL SDS FOUNDATION CAMEO (FAIR) 18.76 1166.00
HOME CARE 103085 IDL SDS FOUNDATION ALMOND (MEDIUM) 18.76 1166.00
33 IDG SA8 GELZYME 1 LITRE 8.62 538.00 103088 ID1 SDS FOUNDATION CARMEL (DARK) 17.96 1116.00
239815 ID PURSUE 5 LITRE 19.12 1188.00 233886 ID ATT. EYE PENCIL - MET SILVER 3.35 208.00
103 IDF PURSUE 200 ML. 1.61 100.00 239111 ID ATT. EYE PENCIL-COBALT BLUE EYEPENCIL 3.69 229.00
137 IDD LOC SACHET 8 ML 0.07 5.00 239112 ID ATT. EYE PENCIL-DEEP PURPLE EYEPENCIL 3.69 229.00
138 IDD DISH DROP SACHET 8 ML. 0.07 5.00 239113 ID ATT. EYE PENCIL-DARK BROWN EYEPENCIL 3.69 229.00
228 IDG DISH DROPS 1 LITRE 6.67 417.00 233889 IDA ATT. EYE PENCIL - KAJAL COAL 3.69 229.00
3417 IDG APSA-80 1 LITRE 8.95 558.00 233890 ID ATT. LIP PENCIL - CHOCOLATE BROWN 3.02 188.00
3941 IDG SEE SPRAY CONC 500 ML 3.07 192.00 233891 ID ATT. LIP PENCIL - FOREVER MAUVE 3.02 188.00
4110 IDG SA8 DELICATE 500 ML. 5.07 317.00 233892 ID ATT. LIP PENCIL - GORGEOUS RED 3.02 188.00
4111 IDG CAR WASH 500 ML. 3.15 196.00 234057 ID LIPSTICK SHINY COPPER 2.80 174.00
7506 IDG PURSUE DISINFECTANT 500 ML 3.27 204.00 234058 ID LIPSTICK EARTHY BROWN 2.80 174.00
8095 IDG LEATHER & VINYL CLEANER 500 ML 3.82 238.00 234060 ID LIPSTICK NATURAL PINK 2.80 174.00
8156 IDG LOC HIGH SUDS 1 LITRE 5.15 321.00 234061 ID LIPSTICK PINK DIAMOND 2.80 174.00
8391 IDG DISH DROP 500 ML. 3.95 246.00 234063 ID LIPSTICK DARK CHOCOLATE 2.80 174.00
8392 IDG LOC HIGH SUDS 500 ML. 3.09 193.00 234064 ID LIPSTICK RED CORAL 2.80 174.00
8393 IDG ZOOM 500 ML 3.09 193.00 231747 IDF NAIL PAINTS PEARL WHITE 1.45 91.00
8945 IDG PREWASH LIQUID 500 ML 4.95 308.00 234065 ID NAIL PAINTS COSMIC DUST 1.45 91.00
8967 IDG SILICONE GLAZE 500 ML 6.00 375.00 234066 ID NAIL PAINTS FIRE STORM 1.45 91.00
100949 IDG APSA-80 500 ML. 5.47 342.00 234067 ID NAIL PAINTS ICY PINK 1.45 91.00
101158 IDG SA8 GELZYME 500 ML. 5.05 316.00 234068 ID NAIL PAINTS METALLIC SAND 1.45 91.00
239814 IDG APSA - 80 5 LTR 37.00 2299.00 234193 ID ATTITUDE CLEANSER-OILY 4.42 274.00
234209 ID ATTITUDE TONER-OILY 4.42 274.00
234210 ID ATTITUDE MOSITURIZER-OILY 6.91 429.00
234214 ID ATTITUDE CLEANSER-DRY 4.42 274.00
234215 ID ATTITUDE TONER-DRY 4.42 274.00
234245 ID ATTITUDE MOSITURIZER-DRY 6.91 429.00
234246 ID ATTITUDE FACE WASH 3.07 191.00
PERSONAL CARE 234248 ID ATTITUDE SUNSCREEN 4.67 291.00
2183 IDG G&H LOTION 250 ML 4.93 308.00 234249 ID ATTITUDE FACE MASQUE 3.47 216.00
2184 IDG NATURE SHOWER. H. SOAP 250 ML 4.93 308.00 234250 ID ATTITUDE HAND & BODY CREAM 3.47 216.00
5030 IDG SAT 2 IN 1 SHAMPOO & COND. 250 ML 4.93 308.00 234293 IDG ATTITUDE FOOT CREAM 3.67 229.00
5050 IDG SAT ADV MOIST DET COND. 250 ML 4.93 308.00 234073 ID MASCARA 4.69 292.00
5060 IDG SAT ADV DC SHAMPOO 250 ML 4.93 308.00 234294 ID EYE LINER 5.04 313.00
5070 IDL SAT. HAIR REJUV. MASQUE 150 ML 5.61 349.00 230396 IDG ATTITUDE DEO FOR WOMEN 2.78 174.00
6826 IDG G & H BODY SHAMPOO 250 ML 4.93 308.00
215358 ID PERSONA TALC POWDER 350 Gms. 2.40 149.00
216916 ID PERSONA TALC POWDER 200 Gms. 1.60 99.00
212738 IDG DYNAMITE SHAVING FOAM 200 Gm 3.58 224.00

1. In case of TNA, would you like Amway to place alternate order for you of the same PVs Yes No
2. The above prices are subject to change. Please check the actual price before placing the order. (Please fill the Ship-To-Address on the reverse side of the order form)
PAYMENT DETAILS
By DD/Cheque (DD/Cheque No. Dt.: By Cash
Bank Payable at By COD Distributor’s Signature
Credit No. Please fill in this form all relevant information before you approach the cashier.
Please present your Amway ID card or copy of SA 88 ID (Application Form)
Card Holder Name Trademarks of Amway Corp. Ada. MI U.S.A. All rights reserved. Printed in India.
Expiry Date (Only Master / Visa Card) P.T.O.
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Receipt (To be filled in by Cashier)
ORDER NO. DATE AMOUNT CASH / CC/ DD / BC/ AR / PC

Cashier’s Signature
SKU NO. Qty. Description PV DAP Total SKU NO. Qty. Description PV DAP Total
Value Value
GREAT VALUE PRODUCTS POSITRIM TOOLS
212737 IDF DYNAMITE SHAVING CREAM 70 gm (PK OF 2) 0.62 78.00 220141 POSITRIM SHAKER 0.00 99.00
230295 IDF PERSONA CLASSIC TOOTHBRUSH (PK OF 4) 1.00 64.00 9572 POSITRIM BMI CALCULATOR 0.00 49.00
230415 IDF PERSONA AMLA OIL 200 ml 0.49 60.00 9573 POSITRIM PEDOMETER 0.00 99.00
230416 IDF PERSONA COCONUT OIL 200 ml (PK OF 2) 0.62 78.00
231227 IDF DYNAMITE HAIR CREAM 150 gm 0.58 73.00
231244 ID DYNAMITE RAZOR (PK OF 10 ) 1.75 145.00
230414 IDG DYNAMITE DEO FOR MEN 2.78 174.00
BSM-ENGLISH
235227 ID NUT. CFV LAUNCH BROC-ENG 0.00 50.00
232124 EAT HARD OR SMART 2008 0.00 50.00
9668 IDF HOME CARE BROC-ENGLISH 0.00 40.00
233008 ARTISTRY BEAUTY BOOK (2) 0.00 80.00
NON-CORLINE 9942 THE MAGIC OF THINKING BIG 0.00 225.00
WHU9965ID OLI VE OIL (1 LTR) 2.93 364.00 9956 PROTEIN 4 EVERY 0.00 75.00
230684 IDC ALL PRODUCT BROCHURE-ENG 0.00 75.00
233306 N & W PRODUCT HANDBOOK (2) 0.00 90.00
236225 APSA ADV. BROCHURE 0.00 30.00

SALES AID
868 250 ML PERSONAL CARE PUMP 0.00 21.00
1404 TURRET TOP CLOSURE 0.00 9.00
1065 PISTOL GRIP SPRAYER 0.00 27.00 BSM-HINDI
1075 SQUEEZE BOTTLE 0.00 18.00 233009 ART. LEARN GUIDE & BEUT BK-H 0.00 80.00
1605 1 L HOME CARE PUMP 0.00 46.00 230684 IDD ALL PRODUCT BROCHURE-HINDI 0.00 75.00
9061 IDA 500 ML HOME CARE PUMP 0.00 46.00 236224 APSA ADV. BROCHURE HINDI 0.00 30.00
9137 BODY SPONGE IVORY COLOUR 0.00 36.00 235421 ID NUT. CFV LAUNCH BROC - HINDI 0.00 50.00
9198 BODY SPONGE PEACH COLOUR 0.00 36.00 9390 IDF HOME CARE BRO - HINDI 0.00 40.00
204239 P & M CAP LOCAL MFG. 0.00 45.00 239187 ID EAT HARD OR SMART HIND 0.00 50.00

C.D.
235229 NUTRILITE FIBER-VCD 0.00 50.00
236230 ID APSA ADV. VIDEO-H-G-B-M 0.00 50.00

BSM-AMSURE
235423 ID LIFELINE SAFETYNETBRO 0.00 25.00

YOUR PARTICULARS : SHIP - TO ADDRESS PLEASE TICK IF DIFFERENT FROM ADDRESS ON FILE (Not available when paying by credit card)
(Only for Home Delivery orders)
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