Sample Retail Sales Receipt Template
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1RSR-US-e
I n d e p e n d e n t D i s t r i b u t o r
Organo Gold International, Inc.
Retail Sales Receipt
7390, Eastgate Rd Suite 190 Henderson Nevada 89011, USA
Customer Service # 1 877 674 2661
INDEPENDENT DISTRIBUTOR INFORMATION
Email:
Name:
Phone:
(
)
-
Distributor ID#:
Fax:
(
)
-
Address:
City:
State:
Zip Code:
PERSONAL CUSTOMER INFORMATION
Name:
Phone:
(
)
-
City:
State:
Zip Code:
Address:
ITEM #
DESCRIPTION
QTY
UNIT COST
TOTAL COST
PAYMENT METHOD:
Sub Total
[ ] Cash [ ] Cheque [ ] Other
Shipping &
( Paypal, Direct Deposit, Wire Transfer, etc. )
Handling*
Transaction Date
Tax
___ /___ /___
* All Orders will be Charged Applicable Taxes, Shipping & Handling.
Total Order
You, the PERSONAL CUSTOMER, may cancel this transaction at any time prior to midnight of the thirtieth business day after the
date of the transaction. Read Notice of Cancellation below this receipt for an explanation of your rights.
NOTICE OF CANCELLATION
You, the PERSONAL CUSTOMER, may cancel this transaction, without any penalty or obligation, within
THIRTY (30)* business days from the transaction date:
( mm/dd/yyyy )
If you cancel, any property traded in, any payments made by you under the contract or sale, and any negotiable instrument
executed by you will be returned within ten (10) business days following receipt by the Independent Distributor of your cancella-
tion notice, and any security interests arising out of the transaction will be cancelled.
If you cancel, you must make available to the Independent Distributor at your residence, in substantially as good condition as
when received, any goods delivered to you under this contract or sale; or you may, if you wish, comply with the instructions of
the Independent Distributor regarding the return shipment of the goods at the Independent Distributor’s expense and risk.
If you do make the goods available to the Independent Distributor and the Independent Distributor does not pick up them up
within twenty (20) days of the date of your NOTICE OF CANCELLATION, you may retain or dispose of the goods without any
further obligation. If you fail to make the goods available to the Independent Distributor, or if you agree to return the goods to
the Independent Distributor and fail to do so, then you remain liable for performance of all obligations under the contract.
TO CANCEL THIS TRANSACTION, MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR
ANY OTHER WRITTEN NOTICE, OR SEND AN EMAIL TO [
] ________________________________
Name of Independent Distributor
at [
] ____________________________________ NOT LATER THAN MIDNIGHT OF [Date] _______________.
( mm/dd/yyyy )
email
I HEREBY CANCEL THIS TRANSACTION.
Personal Customer’s Signature
( mm/dd/yyyy )
NOTE: TWO COPIES WILL BE PROVIDED TO THE PERSONAL CUSTOMER.
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