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Email: MemberServices_Singapore@herbalife.com
Fax: (65) 6416 8458

Non-Resident Declaration Forms / ٫ Ю ‫ ߽ ݚ‬჻ӈ ௝ ‫ ܚ ׯ‬ഺ ଈඇ

(Singapore / ྔࡍ௨ )

I, Shafiq Leong Abdullah (Name) MY642499 (HRBL ID No.) am an Independent

Ɠເ0MZJITQNM؆৲߽჻Ɨࢃ߽ᄎ؇༶ਠഹଃƗᄤՕഹଃѰభඎ๤ၰၢ༶ਠᆴൠརƔƥ
Member of Herbalife and by my signature below, I hereby agree and declare as follows:

‡ ,PD\RQO\SXUFKDVHD´UHDVRQDEOHDPRXQWRISURGXFW··for the purpose of my own personal consumption or

໨ࢃ‫ܚׯ‬õ‫ލ‬য়֬ӈ௝ඛਏöເ۸ಭൗႯࠎ൥ᅃ෉෷ಭᆴႯ๶Ɨ‫ؾ‬٫Ⴏ჆ሎ൹଩֬è
gift, not for resale, in the Republic of Singapore.

‡ “A reasonable amount of product” means an up to two months supply for myself (or a month supply for myself
and spouse) of a reasonable assortment of products, not to exceed 1000 volume points in total in any volume

õ‫ލ‬য়ඛਏöᆴ‫׮‬ၳເӈ௝࣎‫ܛ‬ЮಭൗႯᇇ‫ئ‬਍۸ᄌƓࠎЮಭთ஬஄‫ܒ‬๤ൗႯ၉۸ᄌƔ֬‫ٺ‬ਏƗౖ‫׋ࠑܚ‬
month.

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‡ My purchase is NOT for the purposes of creating retail / business / recruitment opportunities in the Republic

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of Singapore.

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for any adverse consequences.

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‡ ,DJUHHWRIROORZDOORIWKHSUHFHGLQJSRLQWVLQWKLV'HFODUDWLRQDQGDFNQRZOHGJHWKDWQRQFRPSOLDQFHPD\
affect the status of my membership, including but not limited to the suspension of all my Member Rights

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and Privileges.

ٚຽЎ‫࣎҉֓ݪ‬དྷ჆߽჻ಊᆴᄧ๛ࠪᇛᆿè

‡ I also agree to foOORZDOORWKHUUXOHVVHWIRUWKLQ+HUEDOLIH·V5XOHVRI&RQGXFWDQG0HPEHU3ROLFLHVDVZHOO

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‡
Юಭਛࢺᆊ‫ځ‬ഹଃඇࢃთ໨߽֬჻ಊ๤ဩकႼ‫ཹٌލ‬৶è
I understand that this declaration is binding as long as my Membership is valid with Herbalife.

‡ Herbalife reserves the right in its sole and absolute discretion to act against practices which it believes to be
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0MZJITQNMԂႼम‫ؚ‬ಊ৭‫ؚ‬ढ़୆ၟົ٘Юഹଃඇྡྷເᆴ߽჻Ɨეၢᇌᆿࠪӹ‫ه‬è

Shafiq Leong Abdullah 22/02/2019

Name ˋ䓛ԭⲫ䇠ဃ਽ Signatureˋㆮ਽ 'DWHˋᰕᵏ
65