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All rebate claims must include these 3 items to be considered valid: 1) Original UPC code cut from the machine carton; 2) Copy of the sales receipt showing the machine model, retailer where purchased and purchase date; and 3) This claim form – signed and filled out completely.

*Valid on purchase of LB-6800PRW at select retailers and participating Brother Dealer locations between April 15 and May 15, 2011.

PLEASE PRINT YOUR CONTACT INFORMATION

NAME

RETAILER NAME (Required)

STREET*

CITY

PHONE (

  • *

    No Post Office Boxes Allowed.

)

STATE/ZIP

W o u l d y o u l i k e t o r e c e i v e i n f o r m a t i o n f r o m B r o t h e r ? ( c h e c k b o x e s f o r e a c h c h o i c e ) P r o d u c t I n f o r m a t i o n ( i n c l u d i n g s o f t w a r e a n d s e r v i c e u p d a t e s , a n d s p e c i a l o f f e r s ) N e w s ( i n c l u d i n g t i p s , p r o j e c t s , a n d s p e c i a l e v e n t s ) P r e f e r r e d m e t h o d o f c o n t a c t ( c h e c k b o x e s ) A n y m e t h o d E m a i l P h o n e

EMAIL

MACHINE SERIAL NUMBER (Required)

SIGNATURE (Required)

STEPS TO RECEIVE YOUR CLAIM

1. COMPLETE THIS CLAIM FORM. A copy of this Form is available at www.brother.com. Claim must be received by mail at the specific address for the offer. Claims cannot be received by e-mail.

2 . S E L E C T T H E O F F E R Y O U A R E C L A I M I N G : L B - 6 8 0 0 P R W $ 3 0 M A I L - I N R E B A T E , D E P T # 1 1 - 4 7 3 0 7

s

7. MUST BE POSTMARKED BY JUNE 17, 2011. Claim Form and supporting documents (collectively “Claim”) must be postmarked by June 17, 2011. Please allow 6 to 8 weeks to process.

  • 3.

    INCLUDE A COPY OF THE SALES RECEIPT. Submit a copy of the sales receipt showing the product purchased and the purchase date (dated between 4/15/11 and 5/15/11).

  • 4.

    INCLUDE THE ORIGINAL UPC CODE. Submit the proof of purchase by cutting out the original UPC bar code from the side of the carton and the receipt showing the purchase.

MODEL#

UPC BAR CODE#

LB-6800PRW

012502544623

  • 5.

    SIGN THE CLAIM FORM. This form must be signed in order to be valid.

  • 6.

    MAIL ALL OF THE ABOVE ITEMS TO: BROTHER LB-6800PRW $30 REBATE DEPT. 11-47307

    • P.

      O. BOX 540049 EL PASO, TX 88554-0049

Before mailing, did you remember to... Include the original UPC code from the machine box? Include a copy of the sales receipt showing the machine model & purchase date? Select the offer you’re claiming? Address the claim to the correct department number? Write the machine serial number on the Claim Form? Make copies of all your Claim paperwork? Sign the Claim Form?

Incomplete claims (missing paperwork, missing information) will be considered invalid and will disqualify the claim.

OFFICIAL RULES & REGULATIONS

  • Purchases must be made between April 15, 2011 and May 15, 2011. Purchases made before or after these dates will not be eligible.

  • Allow 8 weeks for receipt of rebate.

  • Any misrepresentations or fraudulent information disqualifies the Claim.

  • Offer is not valid in conjunction with any other Brother offer.

  • Brother dealers, distributors, resellers and their employees and internal Brother orders are ineligible.

  • Limit ONE claim per person, household, family or address.

  • Refurbished, used or demo machines do not qualify.

  • Multiple sales to wholesale accounts do not qualify.

  • Only purchases by an end-user customer from select retailers or an Authorized Brother Innov-ís Dealer location in the 50 United States, the District of Columbia or Puerto Rico are valid.

  • Offer void where prohibited by law.

  • Any submission with an invalid or undeliverable address will be rejected.

  • Brother is not responsible for Claims lost, stolen, damaged, illegible, misdirected or delayed in the mail. Please keep copies of all material submitted. No claims against “lost” materials will be evaluated unless accompanied by proof of receipt of the original Claim by Brother (i.e., certified or registered mail).

  • Brother reserves the right to request additional information regarding this Claim and the right to confirm identification. All documentation submitted with this Claim becomes the property of Brother and cannot be returned.

  • The claimant waives any and all claims against Brother relating to this offer.

  • Rebate checks are void 60 days after issue date.

  • Offered by Brother International Corporation and fulfilled by Parago, Inc.

  • To check the status of your claim, call 1-866-441-3015 or visit www.rebateshq.com.

I have read and agree to all the terms and conditions listed on this Claim Form. ©2011 Brother International Corporation. All rights reserved. Brother Industries, Ltd., Nagoya, Japan.

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