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Mail-In Dishwasher Rebate Certificate* IN ORDER TO RECEIVE YOUR $100 REBATE
q D5122aXXL q D5223XXL

January 1 - June 30, 2011
1. Please check the box below, next to the offer you qualify for.

2. Fill in serial number and article number. Serial Number: q q q q q q q q q q q q Article Number: q q q q q q q q The serial number (12 digits) and the article number (9 digits) are located on the product label, on the inside of the dishwasher door. **Failure to correctly complete this will delay processing.**


3. Valid purchase dates: 01/01/11 - 6/30/11 This rebate offer is limited to one rebate per certificate on models D5122aXXL and D5223XXL purchased from an authorized retailer from January 1, 2011 through June 30, 2011. LATE SUBMISSIONS WILL NOT BE ACCEPTED! This certificate must accompany your request. 4. Attach copy of sales receipt or invoice, verifying purchase and delivery, from an authorized dealer. (Dealer quotes not valid) Omission of sales receipt or any other information will delay processing. Offer valid for retail purchases, end-users only. Cannot be combined with any other offer. 5. Please provide contact information.

q qqqqqqqqqqq q qqqqqqqqqqqqqq FIRST NAME LAST NAME q qqqqqqqqqqqqqqqqqqq q qqqq APT. # STREET ADDRESS q qqqqqqqqqqqqqqq q q ZIP qqqqq CITY STATE DATE PURCHASED: q q q q q q q qqqqqqqqq HOME PHONE # M / D /Y q qqqqqqqqqqqqq AUTHORIZED DEALER q qqqqqqqqqqqqq DISTRIBUTOR q qqqqqqqqqqqqqqqqqqqqqqqqqqq E-MAIL ADDRESS
6. Complete, sign and date this form. Customer Signature: ____________________________________ Date: ________________ I hereby understand and accept the above requirements of this rebate. Check must be cashed within 60 days of date of check. ** Rebate(s) may not be available in all markets.** 7. Mail-in the certificate. Must be postmarked no later than July 31, 2011. *Rebates may not be available in all markets. ASKO Appliances, Inc. Dishwasher Rebate PO BOX 940609 Plano, TX 75094-0609


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