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Magazine Rebate Form
Included with your qualifying Shoebuy.com purchase is a magazine subscription valued at $9.99. If you prefer not to receive a magazine and receive a rebate for its stated value, please print and return this form with a copy of your receipt as proof of purchase. Important: fill out all required fields. PLEASE PRINT CLEARLY using capital letters in blue or black ink. First Name (required) __________________________________________ Last Name (required) ___________________________________________ Address (required) (No P.O. Boxes)_________________________________ City (required) ___________ State (required) ___ Zip (required) __________ Phone Number_____________________ E-Mail ______________________ Mail your submission to the following address (must be postmarked within thirty days of purchase): Shoebuy.com Magazine Offer 1127 High Ridge Road #335 Stamford, CT 06905 Include: Copy of your receipt as proof of your purchase. Completed rebate form. Terms & Conditions: Customers must meet all requirements listed in these Terms & Conditions to be eligible for a refund. Please review carefully. You may request a refund for the stated value of the magazine within thirty days of your purchase by sending this form to: Shoebuy.com Magazine Offer, 1127 High Ridge Road #335, Stamford, CT 06905. Be sure to include a copy of your receipt as proof of your purchase. Make copies of all rebate submission materials for your records. Originals submitted will not be returned. Any disputed claim will require photocopy substantiation. Failure to submit any of the required items will result in an invalid submission. Limit one per household. Please allow 6-8 weeks for processing. Offer available to customers within the 50 United States and the District of Columbia. Requests for this offer must be postmarked within 30 days of purchase. No liability is assumed for lost, late, damaged, misdirected, or postage-due mail or requests that fail to be properly delivered to the address stated on this rebate form for any reason. Illegible or incomplete requests will not be honored. Void where prohibited or restricted. Offer maybe withdrawn without notice. I certify that the information I am submitting herewith is honest an accurate and, furthermore, that this rebate request is made wholly without fraud or attempt to deceive as it is made in keeping with the spirit of a legitimate offer and purchase. I understand that I will not be notified if my submission is determined ineligible. Signature:_________________________________ Date:_________________________