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My Account FatBurner+ fat burner plus

900 Wilshire Blvd. St. 202 Troy, Michigan 48084

Tel: 1-800-697-6700

www.FATBURNERPLUS.com

Name and address that will appear on check if different from company listed above

Primary Business: *

Type of Ownership:

Tax Information:

**Please fax a copy of your State Tax ID Certificate
*If your business does not have a federal tax ID #, you must provide your SSN

METHOD OF PAYMENT (We require payment with first order.)

DOMESTIC WHOLESALER TERMS AND CONDITIONS

Rev.12.08.15

these Terms and Conditions may be updated by Vitamin and Supplement Wholesalers, Inc. CVSW°) at a, tirne InAthout notice. Placement of an order is deemed acceptance of Me Terms and Conditions posted when Me order is placed.

1. DEFINITIONS

1.1 "Affiliates" means, with respect to VSW, a, oMer entity directly or indirectly controlling, controlled by or under common control w,th VSW.

1.2 Confidential Intamation. means all confidential and proprietary documents a. information regarding financial and marketing data, projections models contacts research, product plans, products services customers markets software, developments inventions formulas, przsc. retsigns drawings engineering, and hardware configuration information which are not otherwise included IMMin the definftion of Trade secrets

these Terms and Conditions may be updated by Vitamin and Supplement Wholesalers, Inc. CVSW°) at a, tirne InAthout notice. Placement of an order is deemed acceptance of Me Terms and Conditions posted when Me order is placed.

By signing below and clicking Submit, (i) I accept the Terms and Conditions above; (ii) I certify that all information I have provided is true and correct,
and (iii) If I am a health care provider, I acknowledge that I am solely responsible for knowing and complying with the laws governing my practice
and the products and services that I may offer to my patients.