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1. The number shown above is my correct taxpayer identification number (or I am waiting for a number to be issued to
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been
notified by the IRS that I am subject to backup withholding as a result of a failure to report all interest or dividends,
or (c) the IRS has notified me that I am no longer subject to backup withholding; and
3. I am a U.S. Citizen or other U.S. person (defined above); and
4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.
When you invest in a Cellerciser®, you become part of the Cellercise® family.
We are available 9-5 M-F (mst) or by email at firstname.lastname@example.org to answer your questions & to share the best exercises toward your fitness objectives.
Cellercise®, Cellerciser® and Cellology®, The TriDaptable Spring® and the MrRebounder™ program are copyrighted as the exclusive intellectual property of David Hall and Health and Beyond LLC. All rights reserved.
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