Customer Information Member Code : Name : Address : City : State : Phone : PO Box 39597, Los Angeles, CA 90039 Cover Sheet Membership Document Fax: 1-888-355-0777 or e-mail: [email protected] Please mark these check lists (where applicable) before submit application package to Call2Rich. 1. Call 2 Rich Application with Customer Signature 2. Completed W-9 Form with Customer Signature 3. Copy of customer driver license or copy of business identity. 4. Money order or cashier check payable to Call To Rich. 5. Auto Maintaining Program (AMP) Form 6. Credit Card Authorization 7. Copy of front and back of the credit card. Note: For No. 5, No. 6 and No. 7, only for bronze customer position and upper level. *Customer must return all completed forms. These forms effect your commission. Please check your status in www.call2rich.com* <http://www.call2rich.com*> *Customer has 3 ways to return all documents.* 1. Mail to Call 2 Rich Corp. PO Box 39597, Los Angeles, CA 90039. 2. Fax to 1-888-355-0777. 3. e-mail to [email protected] Zip code : PO Box 39597 Los Angeles, CA 90039 USA Toll Free: 1-888-526-8855 Fax : 1-888-355-0777 Email : [email protected] www.call2rich.com Application Form Application Date Application(Individual) First Name Last Name Date of Birth - Marriage Status - Social Security Number - Single Married Widow Gender Male Female Driver License - Email Cell Phone Application(Company) Company Name Contact Name Contact Phone FED ID# Billing Address Shipping Address Street Address Street Address City State Country City Zip code State Country Business/Home Phone Zip code Business/Home Phone Sponser MemberID Name Telephone Email Upline Member MemberID Name Telephone Email Heritage First Name Heritage Relation Last Name Parent Son/Daughter Special Sheet on File Spouse Brother/Sister Grandparent Grandchilds Other Terms and Conditions 1) The undersigned applicant voluntarily seeks to gain membership to "Call 2 Rich Corporation" and hereby agrees to abide the company rules and regulations published on the "Outside Contractors" Manual and Handbook. 2) The undersigned applicant understands the company terms and conditions and is willing to follow and work closely with the counselor or up-line. 3) The undersigned applicant warrants that information completed on the above application form are true and correct. 1) ข ขาพเจ ขาเข ขาใจข ขอตกลงและเงงอ ง นไขตตางๆ ของบรรษษทเปป นอยตางดด และยรนยอมทดจ ง ะปฎรบต ษ ต ร ามอยตางเครตงครษด 2) ข ขาพเจ ขาเข ขาใจเปป นอษนดดแล ขววตา ข ขาพเจ ขาเตปมใจทดส ง มษครเปป นสมาชรก กษบผผ ขแนะนน าทดไง ด ขกรอกรายละเอดยดไว ขข ขางต ขนแล ขว 3) ข ขาพเจ ขาขอรษบรองวตารายละเอดยด ทดก ง รอกข ขางต ขนเปป นความจรรงททก ประการซซงง ข ขาพเจ ขาได ขลงลายมงอด ขวยตษวเองไว ขเปป นหลษกฐาน I agree. (.........................................................) Officer's Signature Date ..../..../........ (.....................................................) Applicant's Signature Date ..../..../........ W-9 Request for Taxpayer Identification Number and Certification Form (Rev. October 2007) Department of the Treasury Internal Revenue Service Give form to the requester. Do not send to the IRS. Print or type See Specific Instructions on page 2. Name (as shown on your income tax return) Business name, if different from above Check appropriate box: Individual/Sole proprietor Corporation Partnership Limited liability company. Enter the tax classification (D=disregarded entity, C=corporation, P=partnership) Other (see instructions) © Exempt payee © Address (number, street, and apt. or suite no.) Requester’s name and address (optional) City, state, and ZIP code List account number(s) here (optional) Part I Taxpayer Identification Number (TIN) Enter your TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN on page 3. Social security number Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose number to enter. Employer identification number Part II or Certification Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and 2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and 3. I am a U.S. citizen or other U.S. person (defined below). Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must provide your correct TIN. See the instructions on page 4. Sign Here Signature of U.S. person © Date © General Instructions Section references are to the Internal Revenue Code unless otherwise noted. Purpose of Form A person who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) to report, for example, income paid to you, real estate transactions, mortgage interest you paid, acquisition or abandonment of secured property, cancellation of debt, or contributions you made to an IRA. Use Form W-9 only if you are a U.S. person (including a resident alien), to provide your correct TIN to the person requesting it (the requester) and, when applicable, to: 1. Certify that the TIN you are giving is correct (or you are waiting for a number to be issued), 2. Certify that you are not subject to backup withholding, or 3. Claim exemption from backup withholding if you are a U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your allocable share of any partnership income from a U.S. trade or business is not subject to the withholding tax on foreign partners’ share of effectively connected income. Note. If a requester gives you a form other than Form W-9 to request your TIN, you must use the requester’s form if it is substantially similar to this Form W-9. Definition of a U.S. person. For federal tax purposes, you are considered a U.S. person if you are: ● An individual who is a U.S. citizen or U.S. resident alien, ● A partnership, corporation, company, or association created or organized in the United States or under the laws of the United States, ● An estate (other than a foreign estate), or ● A domestic trust (as defined in Regulations section 301.7701-7). Special rules for partnerships. Partnerships that conduct a trade or business in the United States are generally required to pay a withholding tax on any foreign partners’ share of income from such business. Further, in certain cases where a Form W-9 has not been received, a partnership is required to presume that a partner is a foreign person, and pay the withholding tax. Therefore, if you are a U.S. person that is a partner in a partnership conducting a trade or business in the United States, provide Form W-9 to the partnership to establish your U.S. status and avoid withholding on your share of partnership income. The person who gives Form W-9 to the partnership for purposes of establishing its U.S. status and avoiding withholding on its allocable share of net income from the partnership conducting a trade or business in the United States is in the following cases: ● The U.S. owner of a disregarded entity and not the entity, Cat. No. 10231X Form W-9 (Rev. 10-2007) PO Box 39597, Los Angeles, CA 90039 Toll Fee: 1-888-526-8855 Fax: 1-888-355-0777 Auto Maintaining Program (AMP) Application(Individual) First Name Last Name Date of Birth - Social Security Number Marriage Status - Single Married Widow Gender Male Driver License - Email Cell Phone Application(Company) Company Name Contact Name Contact Phone FED ID# Billing Address Shipping Address Street Address Street Address City State Country City Zip code Business/Home Phone State Country Zip code Business/Home Phone Condition Customer understands that your position now is........................................ position and you will upgrade to be..................................... position after you sign this form. You have to maintain ........pack (s) amount charge $.......... during you are ..........................position before the 15th of each month. Maintained purchasing package effects your commission. If you fail to maintain this package, you are not qualifying for this position and you will get no commission in that month. Please Initial Payment Option Money Order and Cashier Check Payable to Call To Rich Corp. Please mail to Call To Rich Corp., PO Box 39597, Los Angeles, CA 90039. Auto Charge Payment by credit card. You are hereby authorized, until otherwise instructed, to pay for my monthly maintaining order in the following credit card. VISA Card Master Card Credit Card# .................................... Exp. Date ...................... CVV2 ............................ All orders are subject to the local sales tax of your region and will be added to your order total. Shipping & handling charges will also be added. Auto Maintaining Program (AMP) orders are billed on the 1st-15th of every month. AMP orders will be shipped before 15th of the month. All information must be completed about to ensure processing of your application. I have read and agreed to the terms and conditions, which by reference are fully incorporated into this agreement. ......................................................... ........../......../........... Application Signature Date A participant in the Call To Rich Corp. compensation plan has the right to cancel at any time, for any reason. Cancellation must be submitted in writing to the Call To Rich Corp. at its principal place of business. Female PO Box 39597, Los Angeles, CA 90039 Toll Free: 1-888-526-8855 -----------------------------------------------------------------------------------------------Fax: 1-888-355-0777 email: [email protected] Credit Card Authorization Please print or type *** PLEASE NOTE BELOW I, ............................................... , certify and attest that I am the cardholder of the Master Card/ Visa credit/charge card listed below and that I am an authorized user of same. Purchaser’s Name exactly as it appears on credit card: ................................................................................................................................................................................ Purchaser’s Company Name as it appears on credit cad (if applicable): ................................................................................................................................................................................ Address (Must be same address credit card statement is mailed to): ................................................................................................................................................................................ Credit Card Number Expiration Date: .................................................. ............................................... Security Code (3digits on the back) ..................................................... Issuing Bank Name & Phone Number: ................................................................................................................................................................................ I further certify and attest that as an approved user of this charge/credit card I authorize the Call To Rich Corp. to debit the credit card account listed above for the total amount of: $............................................................................................................................................................................ ..............(Initial) Please check this box if you would like to have an automatic payment to this credit card account. I understand that this transaction is subject to an authorization by the issuing bank and the issuance of an authorization/approval code by same. I further understand that by signing this form I agree to pay all amounts due the Call To Rich Corp. in the event that this transaction is subsequently charged back to the Call To Rich Corp. Date: Signature of Card Holder/Authorized User: ................................... .............................................................. ***In order to process this request, the cardholder must include a copy of their driver’s license and the front & back of the credit card. For Office Use Only Trans. Date:........................ Invoice :...................... Salesperson :....................... Approval Code :...................