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									Swedish Beauty® SALON Claim* Form
Tingle Line: – January 1, 2005 – June 30, 2005
Browning & After-Tan Lines: January 1, 2005 – June 30, 2005
Essence Line by Swedish Beauty: January 1, 2005 – June 30, 2005

This Swedish Beauty Salon SPIFF is for Professional Indoor Tanning Salons. As a salon you can earn $0.75 per
bottle on Unforgiven, $0.50 per bottle on Pink Diamond, all other tingles are $0.25. Simply Divine is $0.75 per
bottle, all other browning and after-tan products are $0.25. Bronze Bodies is not included in the spiff program.
Essence by Swedish Beauty offers a $0.50 rebate on all Phase I and Phase II lotions. Phase III offers a $0.25 rebate
per bottle purchased.

This promotion is good on our bottled products only & does not include sample packets.

Salon Name                                                                                         Salon Phone #
                                                                                                                    (please include area code)

Mailing Address (If mailing & shipping addresses differ, both are required)                        Email Address   _______________________________________________________

Number of salon locations                                                    Salon Owner (please print)
Record Quantities:
Unforgiven_____Bonfire_____ Hot Amaretto_____ Safire_____ Black Diamond w/Hemp _____ Sinful_____

Pink Diamond_____ Dangerously Dark_____ Chocolate Temptation_____ Frosted Hemp_____ Swedish Hemp Crème_____

Simply Divine_____Chocolate Indulgence _____Bronze Faces _____Moisturizer with Bronzer and Hemp ____ Chocolate Silk _____

Browning Syrup _____ Amaretto _____Swedish Bronzing Crème _____Swedish Intensifier_____ Browning Silk _____

Endless Moisturizer____ Body Spray with Hemp____

Phase I:Twilight Glaze_____Opal_____Dark Desire_____                                          Phase II:Hot Desire_____Midnight Glaze_____Ruby_____

Phase III:Renewal Spray_____Crème de L’Essence_____Prolonge_____

Invoices are required as proof of purchase and must include a date and invoice number. Invoices must be legible. Please
highlight the products you are claiming on your invoices so that every product is counted. If you wish to make any claims we
require an updated W-9 tax form to be on file.[for a W-9 form please visit our website at]
*Australian Gold, Inc. will not pay on any claim under $25.00 or keep accruals. Hold all claims under this amount until the
$25.00 figure is reached, then submit the required paperwork.

Signature: _________________________________________ Date: ___________________
The deadline to turn in paperwork is October 31, 2005. Only paperwork dated 1/1/05 through 6/30/05 will be accepted.
To avoid processing delays mail this completed form, invoices and W-9 tax form to the following address and attention:
                                                                             Australian Gold, Incorporated
                                                                             Attn: Customer Service
                                                                             6270 Corporate Drive
                                                                             Indianapolis, IN 46278-2900
Phone 888-865-5108                                                                                                                                      Thank You!
03/04/11 3:43 P.M. Australian Gold, Inc.>E.Bowling<
All paperwork becomes the property of Australian Gold, Inc. & will not be returned.
Australian Gold, Inc. reserves the right to verify any documentation and correct as necessary .

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