75 I N I / O H C / K Y L BEST 1 0 / 1 7 / 1 4 - 1 0 / 1 8 / 1 4 PROMOTION REBATE FORM $ VISA ® PREPAID CARD ON ANY SET OF 4 BEST RATED TIRES INSTALLED! ONLINE OR MAIL-IN REBATE. SEE STORE FOR DETAILS. CANNOT BE COMBINED WITH ANY OTHER OFFER. OFFER VALID AT ANY INDIANA, OHIO OR KENTUCKY DISCOUNT TIRE LOCATION FROM 10/17/14 THROUGH 10/18/14 ONLY. Rebate paid via a Discount Tire Visa Prepaid Card. The card is issued by MetaBank™, member FDIC, or CenterState Bank of Florida pursuant to a license from Visa U.S.A. Inc. Cards are issued in connection with a loyalty, award or promotion program. Card issued in the name submitted on rebate form and is not transferable; card cannot be issued to minors. Card does not have cash access and can be used at any merchants that accept Visa debit cards. Card valid for 6 months in addition to any remaining days in the month of issuance, unused funds forfeit at midnight EST the last day of the month of the valid thru date, subject to applicable law. Country restrictions apply and are subject to change. Card terms, conditions, and limitations apply. Survey DT Offer #INI0047 Receive a $75 Visa® Prepaid Card when you purchase a set of four (4) BEST rated tires at any Indiana, Ohio or Kentucky Discount Tire location from October 17th through October 18th, 2014. (required) We greatly appreciate you taking the time to answer these questions. This information will help us shape future promotions and the way we provide tire service to you. You may submit your rebate online at 1. Did you purchase because of the promotional offer? Yes No using the appropriate offer number. 2. Was this your first visit to any of our stores? Yes No www.dt.rebatepromotions.com Or you may mail ALL of the following REQUIRED items: 1. This redemption form completely filled out (PLEASE PRINT) 2. Your ORIGINAL or STORE ISSUED REPRINT dated sales receipt from the qualifying purchase 3. Please check all the items our promotional offer prompted you to do: Yes No Upgrade your purchase to a better quality tire Yes No Buy a set of four tires rather than one or two Yes No Buy a set of tires somewhat sooner Mail all of these items to: DT Offer #INI0047 P.O. Box 6129 Mesa, AZ 85216 4. How did you first hear about this Promotion? (Please check one) THIS FORM MUST BE POST MARKED NO LATER THAN 11/17/14 • • • • • Purchase must be made at Discount Tire Allow 3–4 weeks for delivery Valid in USA & Canada ONLY Not valid with any other offer Rebates redeemed online must be submitted no later than 11/17/14 Name: TV Radio Billboard Ad Newspaper Mailer/Insert Magazine Search (Google, Bing, Yahoo, etc.) Social Media (Facebook, Twitter, etc.) Email Internet Ad Coupon Site (Fat Wallet, Slick Deals, etc.) Our Website Referred by friends or family While shopping today in this tire store Called store Driving by store Address: City: State:ZIP: To view your rebate status, please visit: www.dt.rebatepromotions.com For questions about your rebate call toll-free at 1-866-892-8078. After submitting required materials, please allow 3 weeks before checking the status of your redemption. Phone Number: WE SUGGEST YOU MAKE A COPY OF ALL MATERIALS SUBMITTED FOR YOUR RECORDS. E-mail Address: Void where taxed, prohibited, or restricted by law. Reinalt-Thomas Corporation DBA Discount Tire is not responsible for late or misdirected mail. Fraudulent submission of multiple requests could result in Federal prosecution under the U.S. Mail Fraud Statutes (18 USC. Section 1341 and 1342) PC 87999