Definity/hankook/cooper Tire Rebate Claim Form

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DEFINITY/HANKOOK/COOPER TIRE
REBATE CLAIM FORM
(Excludes all other brands)
April 4, 2011 – April 9, 2011
CONDITIONS OF ACCEPTANCE:
Please Print Clearly:
To be legally entitled to receive the rebate payment, you must:
1. Purchase any of the listed products at a Pep Boys store
Name
between April 4, 2011 – April 9, 2011.
2. Circle the qualifying items on the REGISTER RECEIPT*
Address
* (If the rebate is for a service or tire offer, we cannot accept a work order or invoice).
3. Complete, sign and date this form. To be eligible for this offer, you must indicate
State
ZIP
City
the Quantity Purchased and Rebate Total for all selected items within this form.
Ensure all requested information is filled in accurately, legibly and completely.
4. Send:
Phone (
)
•This original Completed and Signed rebate form
•Your Pep Boys REGISTER RECEIPT (original or photocopy - NOT THE WORK ORDER
E-mail
OR INVOICE)
I would like to receive e-mail from Pep Boys on product promotions and other Pep Boys services.
5. Requests must be postmarked within thirty (30) days from date of purchase.
6. Make copies of all rebate submission materials for your records. Any disputed
claim will require photocopy substantiation.
Must be signed
and dated
Mail to:
Get exclusive online
Definity/Hankook/Cooper Tire Offer
Signature
Date
SERVICE, PARTS, TIRES
PBA-110403
Please Sign Your Name Here
and ACCESSORY offers
PO Box 753478
By completing this rebate request, I accepted and complied, or will comply with all of the
El Paso, TX 88575-3478
at
Conditions of Acceptance for this rebate offer.
Rebate Offer
Rebate Amount Rebate Limit Item Qty.
Rebate Total
Product
Purchase (4) INSTALLED DEFINITY, HANKOOK or COOPER tires (excludes all
Price paid for
4
other brands)* with tire installation package and receive price paid for one (1) tire
one (1) tire
All purchases MUST INCLUDE the following
TIRE INSTALLATION PACKAGE ITEMS:
- Road Hazard Warranty
- Valve Stems or TPMS Reseal Kits
- Balance
Note: ALL OF THE ABOVE ITEMS MUST BE PURCHASED TO QUALIFY FOR REBATE
*Offer Does NOT include Warrantied and Road Hazard Adjusted Tires
TOTAL EXPECTED REBATE AMOUNT:
Terms & Conditions: Offer valid for purchases at Pep Boys locations in the continental United States and Puerto Rico. Rebate checks will be paid in United States dollars only to United States and Puerto Rico residents.
Rebate Offer cannot be combined with any other offer. Pep Boys is not responsible for lost, damaged or incomplete Rebate Claim Forms or for misprints or typo-graphical errors. Offer is void where restricted or
prohibited. All federal, state and local taxes are the responsibility of the Rebate recipient. Rebate Limit(s) apply per product, per person. To receive your Rebate, you must satisfy all the Conditions of Acceptance
(above). Failure to comply with any of these Conditions of Acceptance will result in a rejection of this Rebate Claim Form. Any inquiries concerning disputes or claims of non-payment must be made by 7/29/11 and will
require photocopy(s) of receipt(s) and completed mail-in Rebate Claim Form. Any such disputes will be governed by the laws of the State of Minnesota. Failure to cash a rebate check within 90 days of issuance shall
void the Rebate Claim and will relieve Pep Boys of any obligation or liability to pay the rebate. Rebate checks cannot be reissued. Fraudulent submissions including multiple requests could result in federal prosecution
under the U.S. Mail Fraud Statutes (Title 18, USC 1341 and 1342). If you have not received your rebate check after 8 to 10 weeks, please call 1-888-829-1420, Monday-Friday, 8 AM – 10 PM EST or check your rebate status
at:

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