0611Item # 11010

I understand that network marketing is a business built on relationships and the retail sale and consumption of products and that Javita International Ltd. believes in maximazing the protection of that relationship. I understand that by changing my sponsor, this will also affect my current upline support.

Step 1 – Evaluate whether the Member is eligible to move as described in the Placement Program section of Javita’s Policies & Procedures.Step 2 – Prepare and submit a completed 60-Day Placement Form.Step 3 – The 60-Day Placement Form must be received on or before the 22nd of the month by 5 p.m. EST to be effective for the current month’s commissions.

NOTE: Javita is not responsible for incomplete, incorrect or lost requests and any lost commissions or rank qualifications as a result. Javita does not agree to make all requested changes by accepting this form. Changes must be reviewed and approved in accordance with Javita’s Policies & Procedures.

Office Use Only

Placement Information

Member requesting placement:

Member to be placed:

Javita system currently shows (current Sponsor)

Requested Change/Placement (new Sponsor):

Area Code Daytime Phone Number

Has this Member been moved before?

60-Day Placement FormTo request a Placement Change, please complete the following form. Fax the completed form to the fax numberbelow or send to: Javita International Ltd. at 7835 NW Beacon Square Blvd., Boca Raton, FL 33487.

Phone: 1-855-JAVITA-1 (1-855-528-4821) • Fax: 1-561-258-2341

E-mail

Member Name (Last, First) Date

Member Name (Last, First) ID#

Current Sponsor Name (Last, First) ID#

ID#Area Code Daytime Phone Number

New Sponsor Name (Last, First) ID#

Member Signature Date

Instructions

Signature