“ORDER FORM”

Upon receipt of payment by the Client as set forth below in this order form (the “Order Form”), AdultVest
hereby agrees to furnish the Client and the Client hereby agrees to license and utilize the online service from
AdultVest (the "Service") only in accordance with the terms and conditions posted thereon and herby
incorporated herewith (the “Terms and Conditions”) and Client herby acknowledges that Client has read,
understands, and agrees to the Terms and Conditions.

Client agrees to pay AdultVest for the Service options according to the schedule set forth below (please mark
off your selection):

___ Month to Month Basic Membership - $99/month billed each month – 15 days written notice to cancel – cancel anytime.
___ Month to Month Premium Membership - $199/month billed each month – 15 days written notice to cancel – cancel anytime.
___ Six Months Basic Membership - $399 onetime payment due on signing – Save $200!!
___ Six Months Premium Membership - $799 onetime payment due on signing – Save $400!!

IN WITNESS WHEREOF, the undersigned have caused this Agreement to be executed and delivered as of the
date set forth on the signature line below.

“CLIENT”
Signature: _______________________________________ Date: ________________________
Print Name:______________________________________ Title:_________________________
Company Name:___________________________________________________________________________
Affiliated Companies:_______________________________________________________________________
Address:__________________________________________________________________________________
__________________________________________________________________________________________
________________________________________________________________________________________
Mobile__________________________ Office_________________________ Home______________________
Fax________________________ Email 1___________________________ Email 2______________________
Websites and DBA’s (attach sheet if needed)_____________________________________________________
__________________________________________________________________________________________
________________________________________________________________________________________

FAX COMPLETED FORM TO: 1-323-330-6481

AdultVest, Inc. 8306 Wilshire Blvd. #300, Beverly Hills, CA 90211

(323) 330-6480 info@adultvest.com
 CREDIT CARD AUTHORIZATION

Print Name as it appears on Card _____________________________________________

Visa or MasterCard Number _____________________________________________

Expiration Date: _____________________________________________

Security Code _____________________________________________

Billing Address: _____________________________________________

_____________________________________________

Business Phone#: _____________________________________________

Business Fax#: _____________________________________________

E-Mail Address: _____________________________________________

Company Name _____________________________________________

I hereby authorize AdultVest, Inc. or an affiliate, successor, or assign thereof to charge my credit card for individual and
recurring charges pursuant to the terms and conditions set forth on the Order Form. My authorization will remain in full
effect for the duration of the term of the Agreement and any extension thereof.

Agreed and accepted,

Print: ________________________________________

Sign: ________________________________________ Date: __________________

FAX COMPLETED FORM TO: 1-323-330-6481

AdultVest, Inc. 8306 Wilshire Blvd. #300, Beverly Hills, CA 90211

(323) 330-6480 info@adultvest.com
 BANK DRAFT AUTHORIZATION

Print Name on Account _____________________________________________

Bank Routing Number _____________________________________________

Account Number _____________________________________________

Check Number _____________________________________________

Bank Name _____________________________________________

Bank Address _____________________________________________

Phone#: _____________________________________________

Fax#: _____________________________________________

E-Mail Address: _____________________________________________

Company Name _____________________________________________

I hereby authorize AdultVest, Inc. or an affiliate, successor, or assign thereof to charge my credit card for individual and
recurring charges pursuant to the terms and conditions set forth on the Order Form. My authorization will remain in full
effect for the duration of the term of the Agreement and any extension thereof.

Agreed and accepted,

Print: ________________________________________ (“Client”)

Sign: ________________________________________ Date: __________________

FAX COMPLETED FORM TO: 1-323-330-6481

AdultVest, Inc. 8306 Wilshire Blvd. #300, Beverly Hills, CA 90211

(323) 330-6480 info@adultvest.com
EMAIL US PHOTOS OR SCAN OR COPY YOUR DRIVERS LICENSE AND THE FRONT / BACK SIDE OF YOUR CREDIT CARD

Front of Credit Card

Back of Credit Card

Drivers License

FAX COMPLETED FORM TO: 1-323-330-6481

AdultVest, Inc. 8306 Wilshire Blvd. #300, Beverly Hills, CA 90211

(323) 330-6480 info@adultvest.com
EMAIL US PHOTOS OR SCAN OR COPY YOUR DRIVERS LICENSE AND THE FRONT SIDE OF A CHECK

Front of Check

Drivers License

FAX COMPLETED FORM TO: 1-323-330-6481

AdultVest, Inc. 8306 Wilshire Blvd. #300, Beverly Hills, CA 90211
(323) 330-6480 info@adultvest.com