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Customer Only Order

Digital Payment

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Purchase Procedure

Payment Instructions

Individual or Business Purchase*

Do you require a Tax Invoice for Business Purposes?*

You may require a copy for tax purposes if being claimed as a business expense

Name of Purchaser*

Contact Phone Number*

Contact Email*

Sponsor Name*

Distributor who is sponsoring this sale

Delivery Address for purchase*

No PO Boxes permitted

Product/s Ordered*

Leveluk K8

SD 501 Platinum

SD 501

SUPER 501

JR 4

ANESPA Shower Spa

Ukon Products

Emguarde EMF Device

You may select multiple items if you wish to purchase

Payment Method*

If Paying By Card

If Paying By Card

Utility Bill < 3 months

If Epayment by direct debit account, please give Account Name, BSB and ACC number for account to be charged monthly

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