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c o m

September 15th through December 31st Customer Name: Address: City, State, Zip Telephone: Where did you purchase? (Store Name and City): Email Purchase Date: Date:

2012 Fall/Winter Rebate

$500 Mail-in Rebate when Purchasing a Heartland Range and Refrigerator Together $750 Mail-in Rebate when Purchasing a Heartland Range, Refrigerator, and Dishwasher Together (All appliances must be purchased on same invoice)

MODEL# (check appropriate box) 30 Classic Dual Fuel Range 4210-CDP (Propane) 30 Classic Dual Fuel Range 4210-CDG (Natural Gas) 48 Classic Dual Fuel Range 5210-CDP (Propane) 48 Classic Dual Fuel Range 5210-CDG (Natural Gas) 30 Classic Electric Range 8210-CD0 48 Classic Electric Range 6210-CD0 30 Classic Gas Range 9200-00P (Propane) 30 Classic Gas Range 9200-00G (NG) 48 Classic Gas Range 7200-00P (Propane) 48 Classic Gas Range 7200-00G (Natural Gas) Oval Wood Cook Stove Non Reservoir 1902-000 Oval Wood Cook Stove With Reservoir 1903-000 Sweet Heart Wood Cook Stove Non Reservoir 2602-000 Sweet Heart Wood Cook Stove With Reservoir 2603-000 Artisan Wood Cook Stove HL-ARTISAN Classic Refrigerator HCBMR19L Classic French Door Refrigerator HCFDR20 Classic Dishwasher HCTTDW TOTAL REBATE CLAIM AMOUNT $

SERIAL #

INVOICE#

See offer requirements on reverse side.

FIN1019 Iss 2

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September 15th through December 31st

2012 Fall/Winter Rebate

Rebate Offer Requirements

Rebates must be submitted by the consumer. Proof of purchase must be provided in the form of a sales invoice from a participating authorized dealer dated September 15, 2012 December 31, 2012. All submissions must be postmarked on or before January 15, 2013. No late submissions will be accepted. 2. To ensure prompt processing of your rebate, please provide all the information requested and list the serial number in the space provided. 3. AGA Marvel is not responsible for lost, stolen, misdirected, damaged claim forms or postage due. 4. Please note that incomplete claims will not be processed. 5. Please allow up to 8 weeks for delivery of rebate after receipt of your claim form. 6. This program cannot be combined with any other offers or discounts. 7. Accessories and parts are not included. 8. AGA Marvel reserves the right to request additional information to verify purchases and to discontinue the program at any time. 9. Submit claim forms to the address or fax number listed below or to email address rebate2012@agamarvel.com. Please keep a copy for your records. 10. Offer valid in the United States only. 1.

Mail To:

AGA Marvel Heartland Rebate 1260 E. Van Deinse St. Greenville, MI 48838 Fax: 616-754-9690

For Internal purposes only: Submitted _______________ Vendor#_______________ AP_______________ Approval_______________

1260 E. Van Deinse St., Greenville, MI 48838 www.agamarvel.com FIN1019 Iss 2

20101129