Rebate Submission Form

Rebate Submission Form
OFFICIAL TERMS & CONDITIONS
April 1 to May 31, 2014 Consumers who buy four Mickey Thompson Baja STZ, Baja ATZP3, Baja MTZ, Baja
Claw TTC Radial, or Deegan 38 tires will receive an $80 Prepaid card by mail or who buy four M/T Classic
III, Classic III Black, Classic Baja Lock, or Sidebiter II wheels will receive a $50 Prepaid Card by mail.
Here’s how:
1. This offer is open to legal residents of the 50 United States, the District of Columbia, and Puerto Rico making purchases in participating retail stores in those locations. The mail-in offer is not transferable and is valid only for
the individual who purchased four new qualifying Mickey Thompson tires or wheels in a single transaction for personal household use. Void where restricted or prohibited by law.
2. Properly submitted and verified claims will be provided with the reward (as described below) in U.S. dollars in the form of a Mickey Thompson Tires Visa® Prepaid Card, to be mailed to the address provided on this official
mail-in form. Cards are issued by Citibank, N.A. pursuant to a license from Visa U.S.A. Inc. and managed by Citi Prepaid Services. Cards will not have cash access and can be used everywhere Visa debit cards are accepted. This
card is not a line of credit, will expire 6 months from the month of issuance, and is subject to the terms and conditions placed on it by Visa and the issuer of the card. Failure to activate or use your Mickey Thompson Tires Visa
prepaid card will void the offer and relieve Mickey Thompson Tires ("Sponsor") of any further obligation. Lost cards will not be replaced after the expiration date. The prepaid card is subject to the terms and conditions placed on it
by its issuer. Sponsor reserves the right to substitute an alternative reward of equal or greater value.
3. This offer is contingent on the purchase of a new set of four qualifying Mickey Thompson tires or wheels (in a single transaction) from April 1 through May 31, 2014. Mail-in requests must be postmarked no later than June 30,
2014 and received no later than July 15, 2014. Late submissions will not be accepted. Allow 6 to 8 weeks after Sponsor receives the mail-in request for delivery of the Visa prepaid card.
4. Reward Amount: Actual reward amount depends on the qualifying tires or wheels purchased and the availability of qualifying new tires or wheels at the time of purchase. $80 reward is available for the purchase of the
following qualifying tires: Mickey Thompson Baja STZ, Mickey Thompson Baja ATZP3, Mickey Thompson Baja MTZ, Mickey Thompson Baja Claw TTC Radial, Mickey Thompson Deegan 38. $50 reward is available for the purchase
of the following qualifying wheels: Mickey Thompson Classic III, Mickey Thompson Classic III Black, Mickey Thompson Classic Baja Lock, Mickey Thompson SideBiter II . Substitutions are not eligible.
5. Limit of one reward per new set of four qualifying tires or wheels purchased in a single transaction. Purchases must be for household use, and offer is limited to two mail-in claims per person, family, household or address.
6. Requests from groups, organizations or businesses will not be accepted. Offer is not available to the affiliated dealers of Sponsor, their respective owners and employees or immediate family members of such owners or
employees. Offer not valid for business or fleet vehicles. Purchaser is responsible for all applicable taxes and other fees. This offer may not be combined with any other Mickey Thompson Tires offer.
7. To apply, complete the mail-in form. This offer is not transferable, so the name on the form must match the name on the sales receipt. Please print clearly in large capital letters. This is the name that will appear on your Visa
prepaid card. Include the original dated sales receipt, which must show the qualifying Mickey Thompson tire or wheel, purchase price, and tire or wheel size. Circle the tires or wheels and size purchased, which must be one set of
four of the qualifying Mickey Thompson tires or wheels. Substitutions are not eligible. Please do not use staples when sending your information. Please mail to: Mickey Thompson Reward Offer # 1023-001, PO Box 753174, El Paso,
TX 88575-3174. No reward will be issued for requests that are not properly submitted (including by not including the documentation described).
8. Keep copies of all documents for your records, as well as a record of the date your mail-in request was mailed. All submitted documents will become the property of Sponsor and will not be returned. Please allow 6-8 weeks
after Sponsor receives the mail-in request for the delivery of your Visa prepaid card. If prepaid card is not received within 8 weeks, contact a Sponsor representative via email at [email protected]
or call 1-877-327-5390. You must notify Sponsor of any claim of non-delivery of your Visa prepaid card by no later than August 30, 2014. Claims of “lost materials” will not be honored unless accompanied by proof of receipt of
materials by Sponsor, such as proof of certified mailing. If you claim a reward was not delivered or was improperly denied, you will be required to furnish Sponsor with a copy of all materials you submitted for verification.
9. Incomplete mail-in requests will delay processing. If any mail-in request is submitted by the deadline but is incomplete, Sponsor's representative will notify the sender by mail, and you must resubmit the request with all missing
information within 10 days of receipt of such notice, together with a copy of the notice.
10.All decisions made by Sponsor (or its authorized representatives) relating to the validity of any submissions are final and binding.
11.U.S. mail fraud statutes prohibit acts devised to defraud or obtain money or property by means of false or fraudulent pretenses if the postal system is involved. This would include, among other things, the use of fictitious or
assumed names or addresses in order to receive multiple offers. Tampering with, altering or falsifying purchase information constitutes fraud. All decisions made by Sponsor (or its authorized representatives) relating to the validity
of any submissions are final and binding. Sponsor reserves the right to disqualify any individual who fails to comply with these terms and conditions or who disrupts or otherwise attempts to affect the administration, security,
fairness, integrity, or proper conduct of this offer. Sponsor reserves the right to confirm the identity of any reward recipient, including collecting information about the recipient from third parties. Sponsor is not responsible for
delayed, postage due, illegible, damaged, mutilated, late, lost, incomplete, stolen or misdirected requests or for typographical or printing errors or other technical problems associated with, or in any materials for, this offer.
12. Sponsor reserves the right, in its sole discretion, to withdraw or amend this offer in any way, or to amend these terms and conditions without prior notice or obligation, in the event of: (i) any error, technical problem, fraud, or
any other cause beyond the reasonable control of Sponsor that interferes with the proper conduct of this offer as contemplated by these terms and conditions; and/or (ii) any accident, printing, administrative or other error of any
kind.
13. In the event of any discrepancy or inconsistency between these terms and conditions and any statements contained in any reward-related materials, including but not limited to the entry form, or point of sale, television, print,
or online advertising, these terms and conditions shall prevail, govern, and control.
14. The offer is governed by, and these terms and conditions will be construed and interpreted pursuant to, the laws of the State of Ohio, without regard to conflicts of law rules that may require the application of the laws of
another jurisdiction. Furthermore, by entering this offer, you agree that any and all disputes, claims, and causes of action arising out of or connected with this offer, or any prizes awarded, shall be resolved individually, without
resort to any form of class action, and exclusively by the United States District Court or the appropriate Ohio State Court located in the Hancock County, Ohio.
15. If you have questions about this offer, contact a Sponsor representative via email at [email protected] or call 1-877-327-5390.
Please Print Clearly and provide ALL information:
Name: ___________________________________________________________________________________________
Address: _________________________________________________________________________________________
City: ___________________________State: _____________ Zip: ___________________________________________
Daytime Phone: ___________________________________________________________________________________
Purchases:
Size__________________________Qty:________________Purchase Date: ___________________________________
Tire or Wheel Model: _______________________________________________________________________________
Purchased From: __________________________________________________________________________________
Mail this completed form and your original dated sales receipt or invoice, postmarked no later than June 30, 2014, to:
Mickey Thompson Reward Offer # 1023-001, PO Box 753174, El Paso, TX 88575-3174
© 2014 Mickey Thompson Performance Tires & Wheels.
Rebate Submission Form
OFFICIAL TERMS & CONDITIONS
FOR CANADA
April 1 to May 31, 2014 Consumers who buy four Mickey Thompson Baja STZ, Baja ATZP3, Baja MTZ, Baja
Claw TTC Radial, or Deegan 38 tires will receive an $80 Prepaid card by mail or who buy four M/T Classic
III, Classic III Black, Classic Baja Lock, or Sidebiter II wheels will receive a $50 Prepaid Card by mail.
Here’s how:
1. This offer is open to legal residents of Canada making purchases in participating retail stores in those locations. The mail-in offer is not transferable and is valid only for the individual who purchased four new qualifying Mickey
Thompson tires or wheels in a single transaction for personal household use. Void where restricted or prohibited by law.
2. Properly submitted and verified claims will be provided with the reward (as described below) in Canadian dollars in the form of a Mickey Thompson Tires Prepaid MasterCard® card, to be mailed to the address provided on this
official mail-in form. Cards are issued by Citibank, N.A. pursuant to a license from MasterCard International and managed by Citi Prepaid Services. Cards will not have cash access and can be used everywhere MasterCard debit
cards are accepted. This card is not a line of credit. It will expire 6 months from the month of issuance and is subject to the terms and conditions placed on it by MasterCard and the issuer of the card. Failure to activate or use your
Mickey Thompson Tires prepaid MasterCard card will void the offer and relieve Mickey Thompson Tire ("Sponsor") of any further obligation. Lost cards will not be replaced after the expiration date. The prepaid card is subject to
the terms and conditions placed on it by its issuer. Sponsor reserves the right to substitute an alternative reward of equal or greater value.
3. This offer is contingent on the purchase of a new set of four qualifying Mickey Thompson tires or wheels (in a single transaction) from April 1 through May 31, 2014. Mail-in requests must be postmarked no later than June 30,
2014 and received no later than July 15, 2014. Late submissions will not be accepted. Allow 6 to 8 weeks after Sponsor receives the mail-in request for delivery of the Mastercard prepaid card.
4. Reward Amount: Actual reward amount depends on the qualifying tires or wheels purchased and the availability of qualifying new tires or wheels at the time of purchase. $80 reward is available for the purchase of the
following qualifying tires: Mickey Thompson Baja STZ, Mickey Thompson Baja ATZP3, Mickey Thompson Baja MTZ, Mickey Thompson Baja Claw TTC Radial, Mickey Thompson Deegan 38. $50 reward is available for the purchase
of the following qualifying wheels: Mickey Thompson Classic III, Mickey Thompson Classic III Black, Mickey Thompson Classic Baja Lock, Mickey Thompson SideBiter II . Substitutions are not eligible.
5. Limit of one reward per new set of four qualifying tires or wheels purchased in a single transaction. Purchases must be for household use, and offer is limited to two mail-in claims per person, family, household or address.
6. Requests from groups, organizations or businesses will not be accepted. Offer is not available to the affiliated dealers of Sponsor, their respective owners and employees or immediate family members of such owners or
employees. Offer not valid for business or fleet vehicles. Purchaser is responsible for all applicable taxes and other fees. This offer may not be combined with any other Mickey Thompson Tires offer.
7. To apply, complete the mail-in form. This offer is not transferable, so the name on the form must match the name on the sales receipt. Please print clearly in large capital letters. This is the name that will appear on your prepaid
MasterCard card. Include the original dated sales receipt, which must show the qualifying Mickey Thompson tire or wheel, purchase price, and tire or wheel size. Circle the tires or wheels and size purchased, which must be one set
of four of the qualifying Mickey Thompson tires or wheels. Substitutions are not eligible. Please do not use staples when sending your information. Please mail to: Mickey Thompson Reward Offer # 1023-001, PO Box 753174,
El Paso, TX 88575-3174. No reward will be issued for requests that are not properly submitted (including by not including the documentation described).
8. Keep copies of all documents for your records, as well as a record of the date your mail-in request was mailed. All submitted documents will become the property of Sponsor and will not be returned. Please allow 6-8 weeks
after Sponsor receives the mail-in request for the delivery of your prepaid MasterCard card. If prepaid card is not received within 8 weeks, contact a Sponsor representative via email at mickeythompsonrewards@young-america.
com or call 1-877-327-5390. You must notify Sponsor of any claim of non-delivery of your prepaid MasterCard card by no later than August 30, 2014. Claims of “lost materials” will not be honored unless accompanied by proof of
receipt of materials by Sponsor, such as proof of certified mailing. If you claim a reward was not delivered or was improperly denied, you will be required to furnish Sponsor with a copy of all materials you submitted for verification.
9. Incomplete mail-in requests will delay processing. If any mail-in request is submitted by the deadline but is incomplete, Sponsor's representative will notify the sender by mail, and you must resubmit the request with all missing
information within 10 days of receipt of such notice, together with a copy of the notice.
10.All decisions made by Sponsor (or its authorized representatives) relating to the validity of any submissions are final and binding.
11.U.S. mail fraud statutes prohibit acts devised to defraud or obtain money or property by means of false or fraudulent pretenses if the postal system is involved. This would include, among other things, the use of fictitious or
assumed names or addresses in order to receive multiple offers. Tampering with, altering or falsifying purchase information constitutes fraud. All decisions made by Sponsor (or its authorized representatives) relating to the validity
of any submissions are final and binding. Sponsor reserves the right to disqualify any individual who fails to comply with these terms and conditions or who disrupts or otherwise attempts to affect the administration, security,
fairness, integrity, or proper conduct of this offer. Sponsor reserves the right to confirm the identity of any reward recipient, including collecting information about the recipient from third parties. Sponsor is not responsible for
delayed, postage due, illegible, damaged, mutilated, late, lost, incomplete, stolen or misdirected requests or for typographical or printing errors or other technical problems associated with, or in any materials for, this offer.
12. Sponsor reserves the right, in its sole discretion, to withdraw or amend this offer in any way, or to amend these terms and conditions without prior notice or obligation, in the event of: (i) any error, technical problem, fraud, or
any other cause beyond the reasonable control of Sponsor that interferes with the proper conduct of this offer as contemplated by these terms and conditions; and/or (ii) any accident, printing, administrative or other error of any
kind.
13. In the event of any discrepancy or inconsistency between these terms and conditions and any statements contained in any reward-related materials, including but not limited to the entry form, or point of sale, television, print,
or online advertising, these terms and conditions shall prevail, govern, and control.
14. The offer is governed by, and these terms and conditions will be construed and interpreted pursuant to, the laws of the State of Ohio, without regard to conflicts of law rules that may require the application of the laws of
another jurisdiction. Furthermore, by entering this offer, you agree that any and all disputes, claims, and causes of action arising out of or connected with this offer, or any prizes awarded, shall be resolved individually, without
resort to any form of class action, and exclusively by the United States District Court or the appropriate Ohio State Court located in the Hancock County, Ohio.
15. If you have questions about this offer, contact a Sponsor representative via email at [email protected] or call 1-877-327-5390.
Please Print Clearly and provide ALL information:
Name: ___________________________________________________________________________________________
Address: _________________________________________________________________________________________
City: ___________________________Province: _____________ Postal Code: _________________________________
Daytime Phone: ___________________________________________________________________________________
Purchases:
Size__________________________Qty:________________Purchase Date: ___________________________________
Tire or Wheel Model: _______________________________________________________________________________
Purchased From: __________________________________________________________________________________
Mail this completed form and your original dated sales receipt or invoice, postmarked no later than June 30, 2014, to:
Mickey Thompson Reward Offer # 1023-001, PO Box 753174, El Paso, TX 88575-3174
© 2014 Mickey Thompson Performance Tires & Wheels.
Formulaire de demande de réduction
MODALITÉS ET CONDITIONS OFFICIELLES
Du 1er avril au 31 mai 2014, achetez quatre pneus Baja STZ, Baja ATZP3, Baja MTZ, Baja Claw TTC Radial
ou Deegan 38 et recevez par courrier une carte prépayée de 80 $. Achetez quatre jantes M/T Classic III,
Classic III Black, Classic Baja Lock ou Sidebiter II et recevez par courrier une carte prépayée de 50 $.
Voici comment procéder :
1. Cette offre est proposée aux résidents légaux des 50 États-Unis, du District de Colombia, de Puerto Rico et du Canada, faisant un achat chez les concessionnaires participants situés à ces endroits. L’offre par courrier n’est pas
transférable et s’applique uniquement aux personnes ayant acheté quatre pneus ou jantes admissibles Mickey Thompson en une seule fois pour leur usage personnel. Nul là où la loi le restreint ou le défend.
2. Les demandes soumises correctement et vérifiées recevront la récompense (décrite ci-dessous) en dollars américains, sous forme d’une carte prépayée MasterCard® Mickey Thompson Tires. Cette carte sera envoyée par
la poste à l’adresse indiquée sur ce formulaire officiel. Les cartes sont émises par Citibank, N.A. suite à un permis de MasterCard International et gérées par Citi Prepaid Services. Les cartes ne donnent pas accès à des espèces
et peuvent être utilisées partout où les cartes débits MasterCard sont acceptées. Cette carte n’est pas une ligne de crédit. Elle expirera 6 mois après la date d’émission et est sujette aux modalités de MasterCard et de l’émetteur
de la carte. Si la carte prépayée Mickey Thompson Tires MasterCard n’est pas activée ou utilisée, l’offre sera annulée et Mickey Thompson Tires (le « Commanditaire ») sera déchargé de toute obligation future. Les cartes perdues
ne seront pas remplacées après la date d’expiration. La carte prépayée est sujette aux modalités et conditions déterminées par l’émetteur. Le Commanditaire se réserve le droit de substituer la récompense par une récompense
différente d’une valeur égale ou supérieure.
3. Cette offre est conditionnelle à l’achat d’un ensemble de quatre pneus ou jantes Mickey Thompson admissibles (en une seule transaction) entre le 1er avril et le 31 mai 2014. Les demandes par courrier doivent être affranchies
et datées le 30 juin 2014 au plus tard et doivent être reçues le 15 juillet 2014 au plus tard. Les demandes tardives seront rejetées. Compter entre 6 et 8 semaines à partir de la date de réception par le Commanditaire pour recevoir
la carte Mastercard prépayée par courrier.
4. Montant de la récompense : le montant de la récompense dépend des pneus et jantes admissibles achetées et de leur disponibilité au moment de l’achat. Une récompense de 80 $ est disponible à l’achat des pneus admissibles
suivants : Mickey Thompson Baja STZ, Mickey Thompson Baja ATZP3, Mickey Thompson Baja MTZ, Mickey Thompson Baja Claw TTC Radial, Mickey Thompson Deegan 38 Une récompense de 50 $ est disponible à l’achat des
jantes admissibles suivantes : Mickey Thompson Classic III, Mickey Thompson Classic III Black, Mickey Thompson Classic Baja Lock, Mickey Thompson SideBiter II. Aucune substitution possible.
5. Limite d’une récompense par groupe de quatre pneus ou jantes neufs admissibles, achetés en une seule transaction. Les achats doivent être destinés à un usage personnel et une limite de deux demandes par courrier par
personne, famille, foyer ou adresse est en vigueur.
6. Les demandes pour les groupes, les organisations ou les entreprises seront refusées. L’offre n’est pas disponible aux concessionnaires affiliés aux Commanditaires, à leurs propriétaires et employés respectifs ou aux membres
de la famille immédiate de ces propriétaires ou employés. L’offre n’est pas valide pour les entreprises ou les véhicules de parc. L’acheteur devra couvrir toutes les taxes applicables et autres frais. Cette offre n’est pas cumulable à
une autre offre sur les pneus Mickey Thompson Tires.
7. Pour faire une demande, remplir le formulaire à envoyer. L’offre n’est pas transférable; le nom indiqué sur le formulaire doit donc correspondre au nom indiqué sur le reçu de l’achat. Veuillez écrire lisiblement, en majuscules
d’imprimerie. Le nom indiqué sur le formulaire apparaîtra sur la carte prépayée MasterCard. Inclure le reçu original de l’achat indiquant la date, les pneus ou les jantes Mickey Thompson admissibles achetés, le prix d’achat et
la taille des pneus ou des jantes. Entourer les pneus ou jantes et la taille achetés, devant être un ensemble de quatre pneus ou jantes parmi les pneus ou jantes Mickey Thompson admissibles. Aucune substitution n’est permise.
Ne pas utiliser d’agrafes lors de l’envoi des documents. Envoyer le tout à Récompenses Mickey Thompson # 1023-001, PO Box 753174, El Paso, TX 88575-3174. U.S.A. Aucune récompense ne sera fournie pour les demandes
incorrectes ou incomplètes (notamment si les documents demandes ci-dessus sont manquants).
8. Garder une copie de tous les documents envoyés pour ses dossiers, ainsi qu’une confirmation de la date à laquelle votre courrier a été envoyé. Les documents fournis deviendront la propriété du Commanditaire et ne seront
pas retournés. Compter entre 6 et 8 semaines à partir de la date de réception par le Commanditaire pour recevoir la carte MasterCard prépayée par courrier. Si la carte prépayée n’est pas arrivée après un délai de 8 semaines,
contacter un représentant du Commanditaire par courriel à [email protected] ou appeler le 1-877-327-5390. Le Commanditaire doit être avisé que la carte prépayée MasterCard n’a pas été reçue
avant le 30 août 2014. Les réclamations de « documents perdus » ne seront pas honorées si elles ne sont pas accompagnées d’une preuve de réception des documents par le Commanditaire, telles qu’un accusé de réception de
lettre recommandée. Si le demandeur affirme qu’une récompense n’a pas été livrée ou qu’elle a été refusée par erreur, le demandeur devra fournir au Commanditaire une copie de tous les documents soumis à vérification.
9. Les demandes par courrier incomplètes entraîneront un retard de traitement. Si une demande est soumise dans les délais, mais qu’elle est incomplète, le représentant du Commanditaire notifiera l’expéditeur de la demande
par courrier, et l’expéditeur devra envoyer tous les documents manquants, accompagnés de l’avis reçu, dans les 10 jours suivants la réception de l’avis.
10. Toutes les décisions prises par le Commanditaire (ou par ses représentants autorisés) concernant la validité des demandes sont définitives et contractuelles.
11. Le statut américain contre la fraude postale interdit tout acte de fraude ou Mastercardnt à obtenir de l’argent ou des biens par le biais de déclarations fausses ou frauduleuses si la Poste est impliquée. Cela inclut, entre
autres, l’utilisa-tion de noms ou adresses fictifs ou inventés dans le but d’obtenir plusieurs offres. Le sabotage, la modification ou la falsification des informations d’achat constituent une fraude. Toutes les décisions prises par le
Commanditaire (ou par ses représentants autorisés) concernant la validité des demandes sont définitives et contractuelles. Le Commanditaire se réserve le droit de disqualifier toute personne ne se conformant pas à ces modalités
ou qui entrave ou cherche à affecter, de quelque façon que ce soit, la gestion, la sécurité, l’équité, l’intégrité ou la conduite appropriée de cette offre. Le Commanditaire se réserve le droit de confirmer l’identité de tout récipiendaire
d’une récompense, y compris de rassembler des informations sur le récipiendaire auprès de tierces parties. Le Commanditaire ne saurait être tenu responsable des retards, des affranchissements insuffisants, des demandes
illisibles, endommagées, mutilées, en retard, perdues, incomplètes, volées ou mal adressées, des erreurs d’impression ou typographiques, ou de tout autre problème technique associé à cette offre ou à tout document afférent.
12. Le Commanditaire se réserve le droit, à sa seule discrétion, de retirer ou de modifier cette offre de quelque façon que ce soit, ou de modifier ces modalités, sans avis ou obligation préalable, en cas de : (i) erreur, problème
technique, fraude, ou tout autre cas au-delà du contrôle raisonnable du Commanditaire, pour gêner la mise en œuvre correcte de cette offre comme le stipulent ces modalités, et/ou (ii) accident ou erreur d’impression,
administrative ou autre erreur, de quelque nature que ce soit.
13. En cas de contradiction ou de différence entre ces modalités et tout énoncé contenu dans les documents concernant les récompenses, y compris, mais sans s’y limiter, au formulaire de participation, aux articles
promotionnels, aux publicités télévisées, imprimées, ou en ligne, ces modalités prévaudront, régiront et feront foi.
14. L’offre est régie par ces modalités et celles-ci seront interprétées en accord avec les lois de l’État de l’Ohio, sans égard aux conflits de règlements pouvant requérir l’application des lois d’une autre juridiction. De plu, en
participant à cette offre, le participant accepte que tout litige, toute réclamation ou toute cause d’action résultant ou en rapport avec cette offre, ou tout autre prix offert, soit résolu individuellement, sans recours collectif quel qu’il
soit, et uniquement par la Cour fédérale des États-Unis ou par la Cour de l’État de l’Ohio, située dans le comté d’Hancock, en Ohio.
15. Pour toute question concernant cette offre, veuillez communiquer avec un représentant du Commanditaire par courriel à [email protected] ou par téléphone au 1-877-327-5390.
Veuillez fournir TOUS les renseignements demandés en caractères d’imprimerie :
Nom et prénom : ___________________________________________________________________________________
Adresse : _________________________________________________________________________________________
Ville : _______________________________ Province : ____________________ Code postal : ____________________
No de téléphone (journée) : __________________________________________________________________________
Achat :
Taille : _____________________________ Qté :________________ Date de l’achat : ___________________________
Modèle des pneus ou des jantes : _____________________________________________________________________
Acheté auprès de : _________________________________________________________________________________
Veuillez envoyer ce formulaire dûment rempli, accompagné de l’original du reçu ou de la facture de vente datés, le 30 juin 2014 au plus
tard, cachet postal faisant foi, à Offre des récompenses Mickey Thompson no 1023-001, PO Box 753174, El Paso, TX 88575-3174, É.-U.
© 2014 Mickey Thompson Performance Tires & Wheels.