Alternate Payer Form
(Credit Card & Paypal Payment)

ENAGIC SINGAPORE PTE LTD

Company’s Registration No. 201135560M
111 North Bridge Road, #25-04 Peninsula Plaza Singapore 179098
Tel: (65) 67207501 Fax: (65) 67207505 www.enagicsg.com

- Please fill in when you agree to pay for the person you specify in this form.

- Enagic Singapore Pte Ltd will not be liable for any misuse credit cards.

- If any issue occurs Enagic Singapore Pte Ltd will not hesitate to terminate your

subscriptions and do necessary arrangements.

I,

ID#

am paying for

(the applicant), in the amount

of

to allow the applicant to register as DISTRIBUTOR / USER.

Also, I hereby agree to the terms and conditions given out by Enagic Singapore Pte Ltd.

Alternate Payer’s Signature

Date

*This information you have provided will be kept confidential and used solely for communicating with you

Alternate Payer Form
(Credit Card & Paypal Payment)

ENAGIC SINGAPORE PTE LTD

Company’s Registration No. 201135560M
111 North Bridge Road, #25-04 Peninsula Plaza Singapore 179098
Tel: (65) 67207501 Fax: (65) 67207505 www.enagicsg.com

- Please fill in when you agree to pay for the person you specify in this form.

- Enagic Singapore Pte Ltd will not be liable for any misuse credit cards.

- If any issue occurs Enagic Singapore Pte Ltd will not hesitate to terminate your

subscriptions and do necessary arrangements.

I,

ID#

am paying for

(the applicant), in the amount of

to allow the applicant to register as DISTRIBUTOR / USER.

Also, I hereby agree to the terms and conditions given out by Enagic Singapore Pte Ltd.

Alternate Payer’s Signature

Date

*This information you have provided will be kept confidential and used solely for communicating with you