CHANGE OF ADDRESS FORM

Herbalife International India Pvt. Ltd. Herbalife

RMZ Pinnacle, No. 15, Commissariat Road Inquiry line for Associates: (+91) 080 – 40311444).
Bangalore, Karnataka, India – 5600025.

If you wish to request a change of address, the following procedure must be followed:
Do you wish to change your (please check):
 Complete this form. Email Address.
 Mail this form using the above to the attention of Associate Services.
Permanent (Legal) / Mailing (Correspondence) Address.
 You may also submit your change of address information directly via
online at https://www.myherbalife.com/en-in/ (If the change is within same country).

All changes will be effective upon the completion / processing of this form by Herbalife.

PERSONAL INFORMATION

Last Name* First Name* Middle Name

Herbalife ID Number *

Previous Email Address

New Email Address

IMPORTANT: If you want to change permanent address, kindly provide any one of the Government issued proof of address in ID holders name, such as Aadhar
Card / Voter ID / Passport / Driving License / Ration Card / Gas Bill / Water Bill / Phone Bill / Electricity Bill / Nationalized Bank Document
along with this form to process your request.

PREVIOUS PERMANENT / LEGAL ADDRESS NEW PERMANENT / LEGAL ADDRESS*

Door # Building Name of Address Door # Building Name of Address

Street Address Street Address

_
City State Zip Code City State Zip Code

Country Code Area Code Phone / Mobile Country Code Area Code Phone / Mobile

Area Code Alternate Phone Area Code Alternate Phone

IMPORTANT: If you want to change Mailing / Correspondence address kindly provide any one of the above documents Or a copy of rental
agreement in ID holder’s Name along with this form to process your request.
By signing this form I acknowledge and consent that Herbalife International India
NEW MAILING / CORRESPONDENCE ADDRESS* Private Limited (“Herbalife")ill collect and process my personal data,
including sensitive personal data, provided in this form for the purposes of fulfilling
its legal and contractual requirements, processing my request, and other business
purposes in accordance with applicable data protection laws and the Herbalife
Door # Building Name of Address privacy policy (available at https://www.herbalife.co.in/privacy-policy) I have read
and understood the privacy policy and understand that Herbalife will retain my
personal data for as long as necessary for the purposes for which it was collected,
Street Address or as long as required by law. I consent that Herbalife may share my data with
Herbalife International of America Inc. and its affiliates, subsidiaries, related parties,
or associates. Herbalife may also share my data with third parties pursuant to the
City State Zip Code Privacy Policy and the Rules of Conduct & Nutrition Club Rules available at
https://www.myherbalife.com/ed/enIN/pages/DocumentsAndPolicies/Policies.html I
Country Code Area Code Mobile / Phone consent that my personal data may be transferred or shared outside of India and
that Herbalife has put in place mechanisms to reasonably ensure that my personal
data shared with Herbalife subsidiaries outside of India are secure at all times and
Area Code Alternate Phone processed in accordance with the laws in India. I understand that I have various
rights in respect to my personal data collected by Herbalife, such as a right to
request access to my personal data, to amend or update inaccurate or incomplete
personal information and request that Herbalife no longer use my personal data. I
may email
privacy@herbalife.com or call member services at +91-08040311444 to make such
a request. I understand that these rights are subject to limitations set out in
Your Signature:* ____________________________ Date: _________ applicable law.

ID holder can have Herbalife permission to duplicate this document. © 2019

Herbalife International of America, Inc. All rights reserved. Rev. MAY/2023