Call for Donation to Nepal Earthquake Victims

Acceptance of Bonus Deduction For

DXN Charity Donation to Nepal Earthquake Fund

Country: ______________________

Distributor Name: _______________________ Distributor Code: _________________

Deduction by percentage (%) on my May 2015 bonus.

5% 10%

Signed by: Acknowledged by:

______________________ ______________________

Name: Country Manager:

Date: Date:

Terms & Conditions

1 All duly signed form should be submitted to the DXN Branch.

2 A scanned or faxed copy of the form is acceptable.

3 DXN only accepts bonus deduction for the donation; cash and other methods of donation are not accepted.

On 25th April 2015, we were all hit with the devastating news of a 7.8 magnitude earthquake in Nepal. Within a few short days, the death toll in Nepal has risen to more than a few thousand victims. It is considered one of the worst earthquakes of this decade with many left destitute. Century-old buildings have crumbled. People have lost their homes and livelihood. Many are struggling without basic necessities like food, water, medication and shelter. In addition, relief and rescue efforts are hampered due to powerful aftershocks.

We, at DXN, are deeply saddened by the plight of our Nepalese brothers and sisters and we would like to do what we can to help them. We know we are not alone in this sentiment and that all of our DXN leaders around the world in Asia, America, Europe and Africa feel the same as us. Many of our leaders have families in Nepal and as one DXN Family, we need to stand by them at their hour of need. Most of us are unable to go there and help with the rescue efforts of many still trapped under the rubble or provide the medical care they desperately need but we can help through monetary means. The financial assistance we give them will aid in the purchase of food, drinks, medication and basic necessities that they need to get by, and it will also help them to rebuild their lives.

Our DXN philosophy has always been to help one another, hence we would like to seek your goodwill to donate generously to the DXN Nepal Earthquake Fund. DXN promises to meet your charitable donation by contributing the same equivalent amount of what you have donated to this fund. Those who would like to make their donation may do so by completing this form and submitting the completed form to your local DXN Branch or main stockist. Let our thoughts and prayers be with our Nepalese brothers and sisters and those involved in the relief efforts while we give generously from our hearts.

I hereby request and authorize DXN to deduct my May 2015 bonus as per the below method.

______% (others please specify)

Deduction by fixed amount which is ____________________ (local currency) on my May 2015 bonus.