DSN Global 100 Revenue Certification & Submission Form Submission Deadline: Friday, March 6, 2020 Please fill out the following company information as well as the Revenue Certification Form located at the bottom of the page and submit to firstname.lastname@example.org Your Name Your Phone Your Email Your Title Company Name Company Country/Headquarters — United States United Kingdom Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People ‘s Republic of China Republic of China Christmas Island Cocos(Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d’Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea – Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Nagorno – Karabakh Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Turkish Republic of Northern Cyprus Northern Mariana Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor – Leste Togo Tokelau Tonga Transnistria Pridnestrovie Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands Isle of Man US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Company City, State/Headquarters Website Top executive officer name Top executive officer title Top executive officer phone Top executive officer email If someone other than the top executive officeralso should be contacted with the nomination information,please submit that person’s information (Optional): Name Title Email Phone Please tell us a bit more about your company: Year Founded Is the company a Party Plan? — Yes No Compensation Plan — Single-Level Multi-Level Products (Select all that apply)Clothing & AccessoriesCosmetics & Personal CareCBD ProductsFood & BeverageHome Décor & Kitchenware & AppliancesHome CareLeisure/EducationalServicesWellnessOther Number of Markets (Countries) in Which you do business Primary Market(Country) Number of Independent active direct sellers at year end 2018 Number of Employees Company Description Please provide your direct selling operations’ net global sales revenue for 2018, before commissions paid and without value-added tax (VAT) in whole dollar amount and without commas. Revenue By clicking SUBMIT, I certify that information presented in this form is true and accurate. Revenue Certification Form (RCF) You can submit your Revenue Certfication Form (RCF) electronically or you can print it off and send it to the email address printed on the form by clicking here. If done electronically, please scroll down to read all of the details to ensure your data is submitted correctly. Thank you!