SUPER REBATE FAX FORM

Sent us a FAX to get your SUPER BUCKS REBATE CHECK

Just print this form, fill it out and fax it to SUPERLAND.
IN THREE EASY STEPS  

... OR .... FILL OUT OUR ONLINE REBATE FORM  LET ME DO IT ONLINE NOW

STEP 1 - TELL US WHERE TO SEND YOUR CHECK .... 

First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone
E-mail

STEP 2 - Please provide the following ORDER INFORMATION ..... 

ORDER NUMBER		From your order print out
ORDER DATE	-- mm/dd/yy	Date from your Order Form
TOTAL ORDER AMOUNT		Including Shipping & Tax (if applicable)
REBATE CODE NUMBER		From the Email you received from SuperLand
YOUR SIGNATURE		Don't forget to sign

Any additional Instructions, Comments ... ?

_________________________________________________________________________________________________________

STEP 3 - FAX this to SUPERLAND at 1-650-368-9378