1. Sponsor Change Request Form
To change a Member’s sponsor, please complete the following form.
Fax the completed form to the fax number below or send to Javita International Ltd. at 7835 NW Beacon Square Blvd., Boca Raton, FL 33487.
Phone: 1-855-JAVITA-1 (1-855-528-4821) • Fax: 1-561-258-2341
Cardholder’s Name (Last, First, Middle Initial) Expiration Date (MM/YY)
0611Item # 11015
Credit Card Security Code (3 or 4 digits) Authorization Signature
Upline Sponsor 1
Upline Sponsor 2
Upline Sponsor 3
Upline Sponsor 4
Upline Sponsor 5
Upline Sponsor 6
Upline Sponsor 7
Upline Sponsor 8
Upline Sponsor 9
Member Name (Last, First) ID#
Current Sponsor (Last, First) ID#
New Sponsor (Last, First) ID#
New Sponsor (Last, First) ID#
I understand that network marketing is a business built on relationships and the retail sale and consumption of products and that Javita International Ltd. believes in maximazing the protection of that relationship. I
understand that by changing my sponsor, this will also affect my current upline support.
I understand that a non-refundable processing fee of $100 will be charged for requesting a change of sponsorship and that all sponsor changes are subject to final approval by the Javita Compliance Department.
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❍ Mastercard®
❍ Visa®
❍ Discover®
❍ American Express®