INDEPENDENT DISTRIBUTOR ORDER FORM (PERU)

NAME:
SERVICE CENTER ID
TELEPHONE:
/ MEMBER ID:
(Effective March 15th, 2020)
DISTRIBUTOR PRICE
CODE DESCRIPTION IGV (incl. IGV) SV PV QTY. TOTAL
S/ S/
FB128 DXN Vita Cafe 18% 67.00 29.20 6.20
FB097 DXN Lingzhi Tea Latte 18% 67.00 29.20 7.00
FB098 DXN White Coffee Zhino 18% 67.00 29.20 7.00
FB109 DXN Lingzhi Coffee 3 in 1 18% 54.00 23.40 4.60
FB121 DXN Spica Tea 18% 54.00 23.60 5.50
FB122 DXN Lingzhi Black Coffee 18% 54.00 23.40 4.60
FB124 DXN Cocozhi 18% 64.00 26.10 6.00
FB125 DXN Spirulina Cereal 18% 117.00 50.20 15.60
FB126 DXN Zhi Mocha 18% 65.00 29.40 6.50
FB143 DXN Zhi Mint Plus 18% 113.00 50.10 12.00
FB063 DXN Zhi Cafe Classic 18% 56.00 26.00 5.50
FB069 DXN Cordyceps Cereal 18% 134.00 57.30 19.00
HF007 RG Powder 18% 99.00 43.00 13.00
HF008 GL Powder 18% 99.00 43.00 13.00
HF002 RG-30 18% 62.00 28.90 5.60
HF004 GL-30 18% 62.00 28.90 5.60
HF001 RG-90 18% 169.00 78.70 15.80
HF003 GL-90 18% 169.00 78.70 15.80
HF034 RG-360 18% 623.00 290.40 52.50
HF035 GL-360 18% 623.00 290.40 52.50
FB007 DXN Morinzhi 18% 57.00 25.30 5.50
FB027 DXN Morinzyme 18% 57.00 25.30 5.50
PC004 DXN Ganozhi Shampoo 18% 47.00 21.00 5.00
PC005 DXN Ganozhi Body Foam 18% 47.00 21.00 5.00
PC006 DXN Ganozhi Toothpaste 18% 30.00 12.80 3.00
PC007 DXN Gano Massage Oil 18% 38.00 16.60 3.80
PC036 DXN Ganozhi Soap 18% 16.00 6.70 1.50
SC020 DXN Aloe. V Cleasing Gel 18% 43.00 18.80 5.20
SC021 DXN Aloe. V Hydrating Toner 18% 43.00 18.80 5.20
SC022 DXN Aloe. V Aqua Gel 18% 57.00 24.90 6.00
SC023 DXN Aloe. V Nutricare Cream 18% 57.00 24.90 6.00
SC024 DXN Aloe. V Hand & Body Lotion 18% 43.00 18.80 5.20
SC032 DXN Aloe. V Facial Scrub 18% 49.00 21.40 5.80
SC033 DXN Aloe. V Hydrating Mask 18% 57.00 24.90 6.60

100 DXN CORPORATE DVD 18% 3.00 - -

105 CORPORATED DVD DXN 2011 18% 2.50 - -
106 INSPIRATIONAL VIDEO 2011 18% 3.00 - -
PEKIT-3 KIT PREMIUM BUSINESS 18% 99.00 15.60 4.60
PEKIT14 BASIC KIT 18% 60.00 - -
P2138 Dato’ Dr. Lim Siow Jin - My Journey with DXN - Spanish 18% 48.20 -- --

HA004 DXN Pressure Cooker 4/6L 18% 600.00 177.90 63.00

WT058 DXN Energy Plus Water System 18% 3,450.00 1169.50 393.00

Z2002 DXN Plastic Bag - Size S 18% 0.40 -- --

Z2003 DXN Plastic Bag - Size M 18% 0.40 -- --
Z2004 DXN Plastic Bag - Size L 18% 0.50 -- --

TOTAL AMOUNT ORDERED: (A)

Please write your complete address SHIPPING & HANDLING: (B)
(For Delivery Purpose): (S/ 30.00 for all shipping & handling)
TOTAL PAYMENT: (A + B)
PLEASE SELECT PAYMENT METHOD:
Bank Information:
BCP (Soles): 194-1840869-0-34
Credit Card / Debit Card
Bonus

SIGNATURE OF DISTRIBUTOR DATE

Av. Angamos Oeste 547,

DXN INTERNATIONAL PERU S.A.C. Miraflores, Lima 18, Peru.
TEL: (511) 241 7148 / 447 7339 / 444 2844 / FAX: (511) 447 8813
Order Form 02032020SP