Three Easy Payments for the Starter Kit Form

DATE :

P.O. Box 550

Riverton, UT 84065-0550

Please fill out the following information completely to take advantage of the Three Easy Payments option for the Starter Kit. You should also
have completed the Independent Demonstrator Application and Starter Kit Order Form.

Completing the following form acknowledges your consent for Stampin’ Up! to charge your credit card for three payments to pay for your
demonstrator Starter Kit. Any commissions earned during the payment schedule will be held until the Starter Kit has been paid in full.

SALE-A-BRATION INSTALLMENT OPTION* (March 13-31, 2009) REGULAR INSTALLMENT OPTION* (April 1-30, 2009)
PAYMENT PAYMENT CHARGED** PAYMENT PAYMENT CHARGED**
Payment #1 (charged at time kit is entered) $56.34 (+ sales tax) Payment #1 (charged at time kit is entered) $66.34 (+ sales tax)

Payment #2 (charged April 15th***) $56.33 Payment #2 (charged May 15th***) $66.33

Payment #3 (charged May 15th***) $56.33 Payment #3 (charged June 15th***) $66.33

Total Payment $169.00 Total Payment $199.00

*Starter Kit paperwork must be received by Stampin’ Up! (not postmarked) by March 31, 2009, to qualify for Sale-A-Bration pricing.
After Sale-A-Bration, Starter Kit paperwork must be received by April 30, 2009, for regular pricing.
**Installment amounts do not include applicable state taxes.
*** This is an approximate date. It may be up to one or two business days after this date.

£ $
 50 Stampin’ Memories Add-On [OPTIONAL] — Check box to select. You may opt to select this additional product to help you more fully showcase our
Stampin’ Memories product line. If you choose this option, the full $50 amount of the Stampin’ Memories add-on and applicable taxes will be included with
your first Starter Kit payment.

By my signature below, I acknowledge I am at least 18 years of age and I agree to allow Stampin’ Up! to use my credit card information, provided below, to charge
three payments for my Starter Kit.

SIGNATURE: DATE:

COMPLETE THIS SECTION FOR Stampin’ Up! RECORDS

CREDIT CARD PAYMENT INFORMATION (All information below for cardholder)

NAME (ON CARD): TELEPHONE NUMBER:

BILLING ADDRESS:

CITY: STATE: CREDIT CARD: £ VISA £ MASTERCARD

ZIP: £ DISCOVER

I authorize Stampin’ Up!:

CREDIT CARD #:
£ To store my credit card information for this and my future purchases.
CARDHOLDER’S INITIALS:
EXP. DATE:
£ To use my credit card information for this purchase only.
AUTHORIZED

CARDHOLDER SIGNATURE:

For Stampin’Up! Internal Use Only

Demo ID Second Billing Date Final Billing Date
Order #

Payment Date Payment Date Payment Date

Payment Amount 1 $ Payment Amount 2 $ Payment Amount 3 $

By By By

COMPLETE THIS SECTION FOR CARDHOLDER RECORDS

CREDIT CARD PAYMENT INFORMATION (All information below for cardholder)

NAME (ON CARD): TELEPHONE NUMBER:

BILLING ADDRESS:

CITY: STATE: CREDIT CARD: £ VISA £ MASTERCARD

ZIP: £ DISCOVER

I authorize Stampin’ Up!:

CREDIT CARD #:
£ To store my credit card information for this and my future purchases.
CARDHOLDER’S INITIALS:
EXP. DATE:
£ To use my credit card information for this purchase only.
AUTHORIZED

CARDHOLDER SIGNATURE:

By signing this form, you give your consent for Stampin’ Up! Inc. to charge your
credit card for three payments (as described in the chart above) to pay for your
demonstrator Starter Kit. Once the first payment is made, you shall be deemed
to have entered into a binding contract for the purchase of the Starter Kit for
the amount set forth in the chart above and Stampin’Up! shall be free to use any
funds paid. Any commissions or earnings that you may earn prior to the date
payment is made in full on the Starter Kit will be held. If for any reason the sub-
sequent two payments are not made, Stampin’Up! may withhold commissions
or compensation otherwise due to you or may take such legal action as shall be
necessary to satisfy the payment of amounts due to Stampin’Up! In such event,
you agree to pay all reasonable costs of collection including attorney fees.

© 2009 STAMPIN’ UP! ALL RIGHTS RESERVED US 03/09