All fields are required except marked as optional.
Please provide accurate information,inaccurate information may delay or invalidate rebate claim.
Make sure you chose the rebate option as described in the rebate.
Rebate check or Non-cash item will be shipped to the shipping address in your original order.
Make sure your order ID is accurate, that is the only way we can verify your order.
We will honor all valid rebate and tries to make the rebate easy, quick and fast, please let us know if you have not received your rebate in 4 weeks after submission
Rebate ID:
First Name:
Last Name:
Zip Code:
Email:
Purchased from:
Purchased date:
// MM/dd/yyyy
Order ID:
Product Name:
Rebate Option:
Rebate Check
Reviewer Name: (exactly as shown in review)
Review Post Date: (MM/dd/yyyy)
Reference ID: (optional)
By submit this claim, I agree all the rebate terms stated in the rebate form with the rebate ID I choose
