LOSE WEIGHT, GET PAID!
with XTREME GREEN COFFEE BEAN EXTRACT Completion Form and Affidavit
First Name:_______________________ Last Name:____________________________________ Address:_________________________________________________________________________ Email:____________________________________________ Birthday:______/______/________
Start Date of the Challenge:_____/_____/______ End Date of the Challenge:____/____/______ Beginning Weight:_______ Current Weight:_______ Pounds lost during the Program:______ Height:_______ft. ________in. I used Xtreme Green Coffee Bean Extract for 3 months? Yes / No
AFFIDA VIT
(This section must be Notarized)
State of _______________________County of_________________________ before me this
___________________________ (name) personally appeared who, being duly sworn, deposes and says: I am the applicant for the Xtreme Green Coffee Bean Extract Lose Weight, Get Paid! Program and I have lost _____ pounds from __________date to _________date, while using Xtreme Green Coffee Bean Extract. The emailed and enclosed digital photographs are my actual before and after pictures.
_____________________________________ Personally Known OR Produced Identification Signature of Affiant
Sworn to (or affirmed) and subscribed before me this _________ day of _______________ 20_______, By ______________________________________________ (name of Affiant).
Notary Signature _______________________________________________________ Print Type or Stamp name of notary and address.
Notary Seal Here
with XTREME GREEN COFFEE BEAN EXTRACT Completion Form and Affidavit
First Name:_______________________ Last Name:____________________________________ Address:_________________________________________________________________________ Email:____________________________________________ Birthday:______/______/________
Start Date of the Challenge:_____/_____/______ End Date of the Challenge:____/____/______ Beginning Weight:_______ Current Weight:_______ Pounds lost during the Program:______ Height:_______ft. ________in. I used Xtreme Green Coffee Bean Extract for 3 months? Yes / No
AFFIDA VIT
(This section must be Notarized)
State of _______________________County of_________________________ before me this
___________________________ (name) personally appeared who, being duly sworn, deposes and says: I am the applicant for the Xtreme Green Coffee Bean Extract Lose Weight, Get Paid! Program and I have lost _____ pounds from __________date to _________date, while using Xtreme Green Coffee Bean Extract. The emailed and enclosed digital photographs are my actual before and after pictures.
_____________________________________ Personally Known OR Produced Identification Signature of Affiant
Sworn to (or affirmed) and subscribed before me this _________ day of _______________ 20_______, By ______________________________________________ (name of Affiant).
Notary Signature _______________________________________________________ Print Type or Stamp name of notary and address.
Notary Seal Here
RULES FOR LOSE WEIGHT, GET PAID! PROGRAM
1. You must be on the (Xtreme Green Coffee Bean Extract) Program for at least 90 days to be eligible for the program, to receive ($5 – five dollars) for every pound you lose.
2. When you receive (Xtreme Green Coffee Bean Extract) be sure to follow all the instructions on each label of our products.
3. The day you receive (Xtreme Green Coffee Bean Extract), Take 2-3 BEFORE photos, front, back, and side facing, of yourself before you start using (Xtreme Green Coffee Bean Extract).
4. One of those photos must show yourself on the scale with your current weight.
5. Use the product every day as directed for 90 days.
6. At the end of your 90 days, Take 3 AFTER photos, front, back, and side facing at the end of the 90 days.
7. One of those photos must show you on the scale with your current weight.
8. You must include a testimonial for (Xtreme Green Coffee Bean Extract). You must enclose with your photos a written permission granting (Xtreme Green Coffee Bean Extract) the rights to post your photos on its website, and use them in any media available now or in the future; including, but not limited to: radio, television and print advertisements for the purpose of promoting the sale of (Xtreme Green Coffee Bean Extract).
Should we decide to use your photos in our advertisement campaign, we might need to verify the authenticity of your photos.
9. Send all 6 photos, your packing slip from each shipment you received, and the notarized form attached to:
Xtreme Green Coffee Bean Extract 1900 W. Chandler Blvd.
Suite #15104
Chandler, AZ 85224
10. You must send in the completed affidavit with correct notarization with your before/after pictures and packing slips to qualify for payment for weight lost during the program.
11. Before and After photo requirements:
Photos must be full body length, front facing, side facing and back with light or white background, wearing a swim suit or tight fitting workout clothes or outfit.
*Before and After Photos must be taken with either a 35mm Film and should include negatives, or digital camera with BEFORE and AFTER photos submitted on a disc. In order to be eligiblefor review, you have no more than 30 days from the last day of your 90 day program to mail in (postmarked) all materials.
Your payment check will be sent out within 30 days of receipt of all required materials if you have successfully qualified for the pay per pound program. You will receive ($5 per pound) for every pound you lose.
REQUIRED PHOTOS:
You will use these poses in both your ‘Before and After’ pictures so that we can easily see the full progress you’ve made during the 90 days. Only colored photos accepted.
1. Full body photo showing you from head to toe.
Adopt a comfortable stance, facing forward, with your arms at your sides, as someone takes the photo.
2. Profile photo showing your body from head to toe.
Using the same comfortable stance described above, simply turn to the side so we can see your entire body.
1. You must be on the (Xtreme Green Coffee Bean Extract) Program for at least 90 days to be eligible for the program, to receive ($5 – five dollars) for every pound you lose.
2. When you receive (Xtreme Green Coffee Bean Extract) be sure to follow all the instructions on each label of our products.
3. The day you receive (Xtreme Green Coffee Bean Extract), Take 2-3 BEFORE photos, front, back, and side facing, of yourself before you start using (Xtreme Green Coffee Bean Extract).
4. One of those photos must show yourself on the scale with your current weight.
5. Use the product every day as directed for 90 days.
6. At the end of your 90 days, Take 3 AFTER photos, front, back, and side facing at the end of the 90 days.
7. One of those photos must show you on the scale with your current weight.
8. You must include a testimonial for (Xtreme Green Coffee Bean Extract). You must enclose with your photos a written permission granting (Xtreme Green Coffee Bean Extract) the rights to post your photos on its website, and use them in any media available now or in the future; including, but not limited to: radio, television and print advertisements for the purpose of promoting the sale of (Xtreme Green Coffee Bean Extract).
Should we decide to use your photos in our advertisement campaign, we might need to verify the authenticity of your photos.
9. Send all 6 photos, your packing slip from each shipment you received, and the notarized form attached to:
Xtreme Green Coffee Bean Extract 1900 W. Chandler Blvd.
Suite #15104
Chandler, AZ 85224
10. You must send in the completed affidavit with correct notarization with your before/after pictures and packing slips to qualify for payment for weight lost during the program.
11. Before and After photo requirements:
Photos must be full body length, front facing, side facing and back with light or white background, wearing a swim suit or tight fitting workout clothes or outfit.
*Before and After Photos must be taken with either a 35mm Film and should include negatives, or digital camera with BEFORE and AFTER photos submitted on a disc. In order to be eligiblefor review, you have no more than 30 days from the last day of your 90 day program to mail in (postmarked) all materials.
Your payment check will be sent out within 30 days of receipt of all required materials if you have successfully qualified for the pay per pound program. You will receive ($5 per pound) for every pound you lose.
REQUIRED PHOTOS:
You will use these poses in both your ‘Before and After’ pictures so that we can easily see the full progress you’ve made during the 90 days. Only colored photos accepted.
1. Full body photo showing you from head to toe.
Adopt a comfortable stance, facing forward, with your arms at your sides, as someone takes the photo.
2. Profile photo showing your body from head to toe.
Using the same comfortable stance described above, simply turn to the side so we can see your entire body.
3. Photo taken from behind showing the back side of your body from head to toe. Again, using the relaxed
stance described above, keep your arms comfortably at your sides as someone photographs your body from
behind.
Dress Code for Photos
• Women must wear a two-piece bathing suit or a tight fitting outfit. • Men must wear form fitting swim trunks or a tighter fitting outfit. Rules for taking a quality photo:
1. Closely follow the instructions for each pose as outlined.
2. To ensure the best quality photos; if you are using a digital camera, set your camera to the ‘best’ image settings and make sure the person taking the photos knows how to use the camera.
3. Clear, focused pictures are essential.
Natural light is especially good for photos, so we suggest photographing yourself either in the morning or the late evening, with flash, when the sun is low, for maximum clarity and detail.
4. Be sure you are photographed against a PLAIN WHITE background - try to minimize any distractions. Also make sure there are no mirrors behind you when using a flash.
5. For digital or 35mm please submit printed photos that are 4x6 inches in size, along with the negatives/disc. Do Not Take Your Photos Outside, or in a poorly lit area. Always use a flash. Do not send us photos from your family album or the box in your closet, as your ‘Before’ or ‘After’ pictures. The impact of taking your ‘Before’ photos can be quite motivating and a few months later, your ‘After’ pictures will be just that much more rewarding. Once your personal transformation begins, you’ll want photographic evidence just to believe your own eyes. Feel free to take as many photos over the course of the Program that you, your family and friends wish to have in your albums to remember the process.
IMPORTANT: As people vary, so do weight loss results. As a sensible part of any weight loss program, reducing caloric intake and regular exercise are recommended. Please consult with your doctor before starting any weight loss program. These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease.
The photos you take for the Program could literally be the end of your old self image! Please read all of the following instructions carefully. Failure to submit the proper ‘Before and After’ photo’s may disqualify you from payment
Dress Code for Photos
• Women must wear a two-piece bathing suit or a tight fitting outfit. • Men must wear form fitting swim trunks or a tighter fitting outfit. Rules for taking a quality photo:
1. Closely follow the instructions for each pose as outlined.
2. To ensure the best quality photos; if you are using a digital camera, set your camera to the ‘best’ image settings and make sure the person taking the photos knows how to use the camera.
3. Clear, focused pictures are essential.
Natural light is especially good for photos, so we suggest photographing yourself either in the morning or the late evening, with flash, when the sun is low, for maximum clarity and detail.
4. Be sure you are photographed against a PLAIN WHITE background - try to minimize any distractions. Also make sure there are no mirrors behind you when using a flash.
5. For digital or 35mm please submit printed photos that are 4x6 inches in size, along with the negatives/disc. Do Not Take Your Photos Outside, or in a poorly lit area. Always use a flash. Do not send us photos from your family album or the box in your closet, as your ‘Before’ or ‘After’ pictures. The impact of taking your ‘Before’ photos can be quite motivating and a few months later, your ‘After’ pictures will be just that much more rewarding. Once your personal transformation begins, you’ll want photographic evidence just to believe your own eyes. Feel free to take as many photos over the course of the Program that you, your family and friends wish to have in your albums to remember the process.
IMPORTANT: As people vary, so do weight loss results. As a sensible part of any weight loss program, reducing caloric intake and regular exercise are recommended. Please consult with your doctor before starting any weight loss program. These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease.
The photos you take for the Program could literally be the end of your old self image! Please read all of the following instructions carefully. Failure to submit the proper ‘Before and After’ photo’s may disqualify you from payment
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