Member-distributor ID#: __________________________________________
Date: __________________________________________________

Name of current owner (seller): ________________________________________________________________________
Name of new owner (purchaser): ________________________________________________________________________

Agreed-upon purchase price: $ ______________________

Upon signing this document, the seller agrees not to compete with the purchaser or attempt to divert or sponsor any existing ICS Member-distributor for the period of one year from the date of the sale or transfer. Upon transfer of this Member-distributorship, seller understands that he or she cannot sign up again as a Member-distributor or co-applicant for the period of six months. The seller also verifies that the purchaser has met the terms of the purchase agreement. The purchaser verifies that he or she has had no beneficial interest in any Member-distributorship for the past six months. A new Member-distributor Agreement must be attached to this Sale of Member-distributorship Form with the information for the purchaser of this Member-distributorship. If the purchaser is a business entity, all necessary business documents (as listed in the Policy Manual) must also be submitted with this form. A transfer fee of $50.00 will be paid by ______________________________________________ .

It will be paid with a:

Credit card: VISA MasterCard _____________________________

Checking: _____________________________

______________________________________
Signature of seller

______________________________________
Signature of purchaser

*This form must be used to transfer ownership from the main applicant to the co-applicant unless: 1 ) the co-applicant is the spouse or cohabitant of the main applicant (see "Simultaneous Interests" policy) or 2 ) the co-applicant has been on the Member-distributorship account for at least six months.