PRODUCT ORDER FORM

SAMI Direct Marketing Pvt. Ltd.

No.30 & 31,5th Main,5th Block, Koramangala, Bangalore- 560034, Karnataka, India
Toll Free No.: 1800 103 9905 . Phone No.: +91 80 4038 1888 . Fax No.: +91 80 4038 1838 . E-Mail: order@samidirect.com

PLEASE FILL IN THIS FORM BEFORE YOU APPROACH THE CASHIER

Date: / /
DD MM YYYY

Please fill below the S.N # of Rs. 500 & 2000

Distributor Name Distributor ID No. Pick-up Qty Total Denomination of Notes

2000/- X
Sponsor Name Sponsor ID Shipment
500/- X
Address (Only required for shipment orders) 100/- X

City State 50/- X

20/- X
Pin Code Mobile No. 10/- X

Coin X
SV Month Payment Mode Cash Dr.Card Cr.Card DD
Total
Order Type FOB Repurchase

SKU (SDNC) NUTRACEUTICALS QTY DP SV BV SKU (SDNC) SALES TOOLS QTY DP SV BV

10211 A Bio-Iron (60 Tablets) 424 93 150 10040 Business Manual - Hindi 50 0 0

10145 Bioprotectant™ (60 Softgels) 1075 237 379 10163 Business Manual - Malayalam 50 0 0

10244 Black Seed (30 Veg Capsules) 808 178 285 10169 Business Manual - Marathi 50 0 0

10068 Calci D Max™ (60 Tablets) 375 83 132 10161 Business Manual - Tamil 50 0 0

10236 Chai – Ginger (10 Tea Bags) 79 12 19 10162 Business Manual- Kannada 50 0 0

10177A Colostrum+ (60 Tablets) 1350 298 476 10168 Business Manual - Punjabi 50 0 0

10207 Coq Energizer™ (45 Softgels) 849 187 299 10184 Business Manual- Telugu 50 0 0

10152 Cran-Dm Plus™(30 Capsules) 900 174 278 10182 Business Manual - Oriya 50 0 0

10213A Curcumin C3 Power™ 525Mg (60 Tablets) 1572 347 554 10183 Business Manual - Urdu 50 0 0

10159A Curcumin C3 Power™ Chewable Tablets (60 Tablets) 291 64 103 10069 Flip Chart 250 20 32

10209A Curcumin C3 Power™ 250Mg (30 Tabs) 503 100 160 10278 Johara Beauty Book (2018) 35 0 0

10210A Curcumin C3 Power™ 250Mg (60 Tabs) 923 150 240 10245 Product Folder 50 0 0

10167A Glycacare® (90 Tablets) 1100 243 388 10229 Sami Direct 16 Pages Brochures -English (5 No’s) 35 0 0

10225 Krill C3 Power (30 Softgels) 1275 246 394 10231 Sami Direct 16 Pages Brochures -Hindi (5 No’s) 35 0 0

10016 Leangard® (60 Capsules) 1800 397 635 10228 Sami Direct Cloth bag – 8” X 10” 5 0 0

10269A LeanGard® All Plant Protein (400 gm) 1088 225 360 10227 Sami Direct Cloth bag – 10” X 14” 10 0 0

10172 Leangard® Classic Protein Powder Mango (250 gm) 616 129 206 10226 Sami Direct Cloth bag – 16” X 21” 15 0 0

10171 Leangard® Classic Protein Powder Mango (500 gm) 1190 249 398 10277 Product Folder - Hindi 55 0 0

10174 Leangard Classic Protein Powder Vanilla (250 gm)

®
616 129 206 10279 Sami Direct Cotton Cloth bag - 10” x 14” Medium 10 0 0

10173 Leangard Classic Protein Powder Vanilla (500 gm)

®
1190 249 398 10280 Sami Direct Cotton Cloth bag - 16” x 20” Large 15 0 0

10282 New : LeanGard Protein Drink Mix – 861 146 234 10264 Black Seed (set of 10 flyers) 10 0 0

Fruity flavor (250 gm)* 10266 Colostrum+ (set of 10 flyers) 10 0 0

10129A Livstrong® (30 Capsules) 1200 265 423 10262 CoQ Energizer® (set of 10 flyers) 10 0 0

10049 Lycopene β™ (30 Softgels) 1000 220 353 10258 Curcumin C3 Power™ (set of 10 flyers) 10 0 0

10056 Macumax™ (30 Capsules) 1250 276 441 10267 GlycaCare® (set of 10 flyers) 10 0 0

10194 Magnesium Effervescent Tablets (20 Tablets) 296 50 80 102265 Krill C3 Power (set of 10 flyers) 10 0 0

10154A Omega Bioplus™ (30 Softgels) 750 165 265 10261 Omega BioPlus (set of 10 flyers) 10 0 0

10132 Organic Spirulina (90 Tablets) 750 165 265 10260 Organic Spirulina (set of 10 flyers) 10 0 0

10146 Osteostrong® (60 Tablets) 1000 220 353 10263 R3 Power (set of 10 flyers) 10 0 0

10142 R3 Power™ (60 Tablets) 1400 309 494 10259 ToxiFlush® (set of 10 flyers) 10 0 0

10234A Samisharp (30 Tablets) 399 88 141 10254 Johara® Broad Spectrum Sunscreen SPF30  (set of10 flyers) 10 0 0

10201A Soeazy™ (150 gm) 572 95 152 10256 Johara® Complete Care Toothpaste (set of 10 flyers) 10 0 0

10155A Toxiflush™ (60 Tablets) 900 198 317 10257 Johara® Daily Feminine Intimate Wash (set of 10 flyers) 10 0 0

10066 Vita Essentials™ (60 Tablets) 900 174 278 10253 Johara® PhytoBright™ Whitening Cleanser (set of 10 flyers) 10 0 0

10157 Book - Curry Powder To Clinical Significance 630 0 0 10255 Johara® Refreshing & Nourishing Bath Bar (set of 10 flyers) 10 0 0

10198 Brochure 12 Fold (10 Nos)- Malayalam 55 0 0

10160 Business Manual - Bengali 50 0 0

10025 Business Manual - English 50 0 0

Distributor Signature: Order Processed By: Invoice No.: Date:

Note: Our order processing timing is from Monday-Saturday from 9.030 am - 6.00pm, Sunday holiday Bank in the order amount in IDFC Bank A/c No: 10005351314
Branch: Residency Road- Bangalore IFS Code: IDFB0080151; SBI A/c No.: 32101734010 Branch: Koramangala, Bangalore; IFSC: SBIN0010508 ; IDBI Bank Ltd
A/c No.: 0008102000054658 Branch: Mission Road, Bangalore IFS Code: IBKL0000008 All Prices are inclusive of taxes Shipping Charges are applicable as per the courier policy
www.samidirect.com
* Launching on April - 2019
 PRODUCT ORDER FORM
SAMI Direct Marketing Pvt. Ltd.
No.30 & 31,5th Main,5th Block, Koramangala, Bangalore- 560034, Karnataka, India
Toll Free No.: 1800 103 9905 . Phone No.: +91 80 4038 1888 . Fax No.: +91 80 4038 1838 . E-Mail: order@samidirect.com

SKU (SDNC) JOHARA® SKIN CARE QTY DP SV BV SKU (SDNC) JOHARA® BODY CARE QTY DP SV BV
10252 PhytoBright™ Whitening Cleanser (50ml) 240 41 65 10246 Refreshing & Nourishing Bath Bar 140 20 32
10074 PhytoBright™ Whitening Mask 360 76 122 10131 Amaranthus & Amazon Lily Body Lotion 239 51 81
10075 PhytoBright™ Whitening Essence 960 203 325 10208 A Neem Hand Sanitizer (75 ml) 96 12 19
10076 PhytoBright™ Dark Spot Corrector 600 127 203 10224 A Daily Feminine Intimate Wash 159 36 57
10071 PhytoBright™ Whitening Day Lotion with SPF 20*** 720 153 244 10281 New : Turmeric bath bar (set of 3)* 160 21 34
10072 PhytoBright™ Whitening Night Cream 720 153 244
SKU (SDNC) JOHARA® FRAGRANCE QTY DP SV BV
10130 Instant Radiance Face Scrub 400 85 136
10165 Secret Crush eau de parfum 1599 339 542
10232 Ultra Hydration Crème 359 76 122
10166 Raw Pour Homme 1599 339 542
10233 Anti-Aging Under Eye Firming Cream with CoQ10 240 51 81
10237 Anti-Aging Clarifying Cleanser (Combination/oily) 300 64 102
10238
SKU (SDNC) JOHARA® SUN CARE QTY DP SV BV
Anti-Aging Creamy Cleanser (Normal/Dry) 300 64 102
10112 Broad Spectrum Sunscreen SPF 30 380 81 129
10243 Anti-Aging Balancing Toner 239 51 81
SKU (SDNC) JOHARA® EYE COLOR QTY DP SV BV
10241 Anti-Aging Day Defence Broad Spectrum SPF 30 639 135 217
10093 Deep Impact Kajal 260 55 88
10242 Anti-Aging Firming Night Rejuvenating Serum 639 135 217
10094 Expert Pen Eyeliner 460 97 156
10240 Anti-Aging Revitalizing Moisturizer(Combination/oily) 399 85 135
10239 Anti-Aging Revitalizing Moisturizer (Normal/Dry) 399 85 135 SKU (SDNC) JOHARA® ORAL CARE QTY DP SV BV
10250 Anti-Aging Kit (Combination/Oily) 1599 10197 A Complete Care Toothpaste (50 g) 56 05 08
339 542
10251 Anti-Aging Kit (Normal/Dry) 1599 10195 A Complete Care Toothpaste (100 g) 96 09 14
339 542
SKU (SDNC) JOHARA® NAIL COLOR QTY DP SV BV
10249 Spring Summer Gloss Collection (Pack of 3) 159 34 54
10248 Spring Summer Matte Collection (Pack of 3) 159 34 54
SKU (SDNC) JOHARA® Crème Rich Lip COLOR QTY DP SV BV
10272 Johara® Crème Rich Lip - Color - Poppy Pink 319 54 86
10273 Johara® Crème Rich Lip - Color- Scarlet Red 319 54 86
10274 Johara® Crème Rich Lip - Color- Bridal Pink 319 54 86
10275 Johara® Crème Rich Lip - Color- Bold Red 319 54 86
10276 Johara® Crème Rich Lip - Color- Coral Orange 319 54 86

SKU (SDNC) PROMOTIONS QTY DP SV BV

From 4th April 2019 to 30th April 2019 Available on repurchase only or till stocks last
10209 A Buy 3 Curcumin C3 Power 250 mg (30N Tablets) & get 1 free 1509 257 411
10132 Buy 3 Organic Spirulina & get 1 free 2250 438 701

From 5th April 2019 to 30th April 2019 Available on repurchase only or till stocks last
10248/
10249 Buy any 1 Johara® Nail Color Spring Summer Collection & get any 1 free 159 17 29
10251 Buy 1 Johara® Anti-Aging Kit Normal/Dry Skin & get 1 free 1599 189 302
10250 Buy 1 Johara® Anti-Aging Kit Combination/Oily Skin & get 1 free 1599 182 291
10224 A Buy 1 Johara® Daily Feminine Intimate Wash & get 1 free 159 18 29
10076 Buy 1 Johara® PhytoBright™ Dark Spot Corrector & get 1 free 600 114 182
10208 A Buy 3 Johara® Neem Hand Sanitizer & get 1 free 288 22 35
10112 Buy 1 Broad Spectrum Sunscreen SPF 30 & get 1 free 380 54 86
PROMOTION EXTENDED till 30th April 2019
10282 Buy 2 LeanGard Protein Drink Mix – Fruity flavor (250 gm) & get 1 free ( On Repurchase 1722 225 360
and FOB Also
10281 Buy 3 Turmeric bath bar (set of 3 ) & get 1 free (On Repurchase only) 480 48 77

www.samidirect.com