Official P2 and BT Monitor Rebate Claim Form: May 15, 2013 to September 30, 2013

Receive a Panasonic Visa

(R)

Prepaid Card with a rebate from the purchase of one of the listed P2 HD products:

AG-HPX255PJ ($400) / BTLH2170PJ ($400) / BTLH1850PJ ($300) This promotion is valid between the dates of May 15, 2013 and September 30, 2013. completed. Date_________________________________________________________________________________ Name________________________________________________________________________________ Address (No P.O. boxes)_________________________________________________________________ City_______________________________State _________ Zip__________________________________ Email Address _____________________________________Phone Number________________________ Reseller Name__________________________________________Date of Purchase__________________ Type of Video Produced (circle or write in Other): Broadcast, Cable, Commercials, Corporate, Education, Event, Government, Independent Production, Legal, TV/ Cine Production, Religious, Sports, Other__________________________ Please print legibly and all fields must be

Camcorder/Monitor (Model) 1. 2. 3. 4. 5.

Serial Number

Rebate Amount

TOTAL: Failure to give full model number and serial number will result in the claim being rejected.)

Signature____________________________________________________________________
Guidelines:
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. You must have purchased a Panasonic AGHPX255PJ, BTLH1850PJ, or BTLH2170PJ between the dates of May 15, 2013 and September 30, 2013. You must return this completed form, along with a copy of your sales receipt of the eligible model with the purchase price circled, as well as the UPC code and serial number cut from your AGHPX255PJ, BTLH1850PJ, or BTLH2170PJ product cartons. Submittals must be postmarked within 30 days from date of purchase to qualify. Product must be new and unused. This offer is only available to the end user and original purchaser. No claims from resellers, dealers/distributors, their employees or warehouse facilities, groups, clubs or organizations will be accepted or acknowledged. No P.O. boxes accepted except military APO/FPO (Air/Army Post Office or Fleet Post Office) addresses. May not be combined with any other offer or fulfillment. Fraudulent submissions could result in Federal prosecution under the U.S. Mail Fraud Statutes (18 USC, 1341 and 1342). Offer void where taxed, prohibited or restricted by law. Offer good only a) on US Product, purchased in the 50 states of the United States and D.C. and b) to current U.S. residents only. Exception for U.S. military personnel overseas. Prepaid Cards may not be used by persons under 18 years of age. Panasonic Corporation of North America (Panasonic) is not responsible for late, lost or misdirected mail. Panasonic Prepaid Card offers are ordinarily delivered within 814 weeks. Go to Prepaid card companys site for card details. See Web Address in prepaid card disclaimer box below. Panasonic reserves the right to audit any claims and to nullify any claims that cannot be substantiated. Panasonic reserves the right to amend the rules of the program or cancel this promotion without prior notice. Submitted claim material becomes the property of Panasonic and will not be returned. Please retain a copy of your submission for your records.

Mail your completed claim form to:

Official P2 and BT Monitor Rebate Claim Form P.O. Box 1919, Memphis, TN 38101

QUESTIONS? Call 8663394296to check the status of your reward card.

Prepaid card is issued by MetaBank, Member FDIC, pursuant to a license from Visa U.S.A. Inc. The prepaid card is given to you as a rebate and no consideration, value, or money has been paid by you in exchange for the prepaid card. Card issued in the name submitted on rebate form and is not transferable; card cannot be issued to minors. Card does not have cash access and can be used at any merchants that accept Visa debit cards. Card valid for up to 6 months, unused funds forfeit at midnight EST the last day of the month of the valid thru date, subject to applicable law. Country restrictions apply and are subject to change. Card terms, conditions, and limitations apply; see MyPrepaidCenter.com/site/visa-promo for details.