eBIZ.com Pvt. Ltd. eBIZ House B-18, Sector - 63 NOIDA - eBIZ.com Pvt. 201301 U.P.

INDIA INVOICE FORM (FREE ASSOCIATE) Associate Name MR SIDDHAYYA HIREMATH Date of Birth 11-19-1992 Mailing Address GHURBI GULBARGA GULBARGA-585321,KARNATAKA INDIA Contact No. 9880014191 PAN NA Registration Date 02-12-2013 Sponsoring Associate MR SHARATH KUMAR N . . Account Details: User Name Distributor Id siddu_007 5072296 . Package Details:
Free Basic eBIZ Educational Package Annual Maintenance Charge Service Tax @10% Education Cess@ 2% Secondary Cess@1% 0.00 Total Amount 0.00 0.00

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Rs. 0.00

Rs. 0.00

Rs. 0.00

. DECLARATION : Certified that I am atleast 18 years of age and have completed atleast 10th grade of schooling. I have received complete Free Basic eBIZ Educational Package online immediately after registration. I am completely satisfied with eBIZ Product. I have completely understood how to learn courses given in Free Basic eBIZ Educational Package online by myself (using Computer and Internet at my own cost). I have carefully read the Terms and Conditions and FAQs applicable to eBIZ.com Pvt. Ltd. as given on website www.ebizel.com and agree / accept to them. I am signing this DECLARATION with complete understanding and with my own WILL, without any PRESSURE / UNDUE INFLUENCE and INDUCEMENT. I am aware that any dispute arising out of this purchase would first be solved as per Terms and Conditions of the company, failing which could be addressed exclusively in Noida / Delhi jurisdiction only. Verified that the above information provided and the DECLARATION made by me is correct in all respects. Signatures of Free Associate Please take a print of this Invoice Form and send us duly signed in Invoice Form at the address given above.Registering Associates must keep a photo copy of this Invoice Form for their own records. Service Tax Reg. No. AABCE3009PST001

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