Clearasil Ultra® 5 in 1 Try Me Free Enjoy visibly clearer skin for free with mail-‐in rebate. Thank you for your recent purchase of Clearasil Ultra® 5 in 1 product. To receive your rebate (up to $5.99), simply follow the steps below*. To receive your rebate, please mail: 1) A completed Rebate form (this form), 2) The original cashier register receipt dated between 4/26/15 and 6/6/15 showing purchase of (1) single Clearasil Ultra 5 in 1 product with date and purchase price circled 3) Picture and/or documentation of UPC code from the Clearasil Ultra® package in which you purchased, to: Clearasil 5 in 1 PO Box 2793 Grand Rapids MN 55745-‐1793 Please print clearly – proper delivery depends on a complete and correct address. Phone Number: ( ) First Name: Last Name: Address: Apt #: City: State: Zip Code: Date of Birth (DD/MM/YY): E-‐mail Address: *ADDITIONAL TERMS Offer valid on purchase of ONE (1) unit of Clearasil Ultra® 5 in 1 product between 4/26/15 and 6/6/15. Request must be postmarked by 6/20/15 and received by 7/18/15. Offer is valid in the US only. Void in CT, RI and where prohibited. Limit one refund per household. Use of multiple addresses or PO boxes to obtain additional refunds is fraud and may result in prosecution. Multiple submissions will not be acknowledged or returned. This try me free is limited to the purchase price and excludes incidental or consequential damages, negligence, strict liability or any other legal theory. Some states do not allow the exclusion of incidental or consequential damaged, so the above limitation or exclusion may not apply to you. This try me free will give you specific legal rights and you may also have other rights, which vary from state to state. A copy of the UPC and receipt must accompany this form. Reproduction, sale, trade or purchase of this form or proof of purchase is prohibited. Proof of purchase must be obtained from product purchased by you. No request from groups, clubs or organizations will be honored. Please allow 6-‐8 weeks for delivery. All information you give to us will be kept private and will not be sold to any other company.