HER BAL1FE W NUTRITION
f- C,, HER BAL1FE W NUTRITION
Email: [email protected] Herballfe Australasia Pty Ltd. PO Box 61 MARLESTON, SOUTH AUSTRALIA 5033 Phone: (08) 8154 0200 Fax: (08) 8234 3605
BANK INFORMATION FORM
AUSTRALIAN LOCAL ENTITLEMENTS
Return this completed form by mall, fax or scan and email to the address supplied above.
Please allow 10-14 days for processing. Please consult your Career Manual for information on requirements to receive earnings.
MEMBER INFORMATION
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Last Name
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Herbalife ID Number
First Name
Middle Name
Day Phone Number
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Mobile Phone Number
AUSTRALIAN BANK ACCOUNT INFORMATION
Please deposit my local net earnings to the Australian bank account I have listed below:
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Account Name (the name which this account is held)
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Financial InstItution
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BSB Number (Bank/State/Branch)
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Member Agreement to Process EFT Payments I authorise Herbalife to deposit my net earnings, or any other sums due to me, and to make error adjustments if they should occur, to the account identified above. This authorisation shall remain effective until revoked. I further understand and agree that the bank engaged by Herbalife to originate payments (Originating Bank) shall have no liability for the failure of any deposit to reach my account in a timely and accurate manner, provided that the Originating Bank has not acted with gross negligence or misconduct. I also understand that Herbalife will confirm information above and will take reasonable steps to ensure that information that is collected from me Is accurate and will take reasonable steps to ensure that such information remains accurate, timely and secure. I understand that Herbalife will use my personal information in compliance with its privacy policy which can be found in the Member Manual. I understand that my information will be shared with the Originating Bank and that any use made of my information by the Originating Bank is subject to the privacy policy of that Originating Bank. I agree not to hold Herbalife or the Originating Bank responsible for harm as a result of any breach of confidentiality relating to the information I provide to Herbalife. I agree Herbage will pay fees to the Originating Bank for this service, my bank may charge additional fees to receive payments that are for my account. I acknowledge that Herbalife and the Originating Bank reserve the right to revoke my enrolment for regulatory, gross negligence or other reasons.
Your Signature: 4t,c; Date: //1 /2 ca
0 2014 Herbalde Australasia Pty Ltd. All rights reserved. AS Rev. 07114
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HER NUTRITION BAL1FE
Email: [email protected] f- C,, HER BAL1FE W NUTRITION PO Box 61 MARLESTON, SOUTH AUSTRALIA 5033 Phone: (08) 8154 0200 Fax: (08) 8234 3605 Herballfe Australasia Pty Ltd.
INFORMATION FORM FOR THE BANK
LOCAL ENTITLEMENTS IN AUSTRALIAN
Return this completed form to the above address by mail, fax, or scan and email.
Processing time ranges from 10 to 14 days. Please refer to your Career Manual for details on the requirements for receiving pay.
INFORMATION FOR MEMBERS
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H
I
H
E
0
C
Name of Last Name
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3
Herbalife ID Number
First Name
Middle Name
Day Phone Number
c
3
Mobile Phone Number
AUSTRALIAN BANK ACCOUNT INFORMATION
Please deposit my local net earnings to the Australian bank account I have listed below:
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0
M
0
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