Kohl'S Rebate Event Form

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Kohl’s December $10 Rebate Event
SEND:
A.) This original or copy of the completed mail-in
request form.
B.) The original or copy of the cash register receipt
BUY: Purchase items between 12/11/11 - 12/12/11 only.
with purchase circled.
C.) The original UPC bar code symbol from the
$10 Mail In Rebate:
package (must include the original UPC barcode
TRU Triple Slow Cooker
symbol with MODEL# attached from the package
- Model # BS-75SK - UPC 06-55772-00852-7
for verification.)
Ninja Master Prep Professional
MAIL TO:
Kohl’s December $10 Rebate Event
- Model # QB1004
- UPC 06-22356-52978-5
Dept. 067-108
PO Box 6008
Babycakes Cake Pops Maker
Grand Rapids, MN 55745-6008
- Model # CP-94LV
- UPC 06-55772-00849-7
RECEIVE:
FoodSaver V850
A Kohl’s Rebate by mail.
- Model # T000-22390-027 - UPC 00-53891-10448-7
Limit 2 per person per model number purchased
5QT Programmable Slowcooker
per household.
- Model # SCRP500-SP
- UPC 00-48894-04304-8
Name:_____________________________________________________________________________________________________________
Address:__________________________________________________Apt:____________ Email:_____________________________________
(No P.O. Boxes)
City:___________________________________ State________ Zip:_____________________Phone:_________________________________
Submissions must be postmarked by 1-12-2012 to be eligible, limit 2 per person per model number purchased per household. No Post
Office Boxes allowed, only streetor rural route addresses are acceptable. Products for which item is claimed may not be returned. Fraudulent
submissions of multiple requests couldresult in federal prosecution under U.S. Fraud Statutes (18 USC, Section 1341 and 1342). Sponsor is not
responsible for lost, late, damaged, illegible, misdirected or postage-due submissions. This offer is void where prohibited, taxed or restricted by
law. Requests from groups or organizations will notbe honored. Offer good in U.S.A. only. Allow 6-8 weeks to process your submission. If you
do not receive your item after 8 weeks, please visit or call 1-800-620-2853. Keep copies of all
materials submitted for your records.

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