SA_0416_B SA_APR #2 SAMSUNG LAUNDRY PAIR REBATE Program: Consumers who purchase select Samsung® laundry products will receive a $100 pair rebate. Program Period: Supplier ID Number: Arris ID Number: Claim By Date: Issue Date April 17, 2016 - April 26, 2016 SA_APR #2 Sa_0416_B May 26, 2016 March 3, 2016 Program Details: Must purchase (1) washer and (1) matching dryer to qualify. Top Load Washers Top Load Dryers WA48H7400AW DV48H7400** WA48J7700AW WA52J8700A** + DV48J7700** DV52J8700** WA56H9000A** DV56H9000** Front Load Washers Front Load Dryers WF42H5200AP** DV42H5200** WF45H6300A** WF56H9100A** + DV45H6300** Rebate Amount $100 Rebate Amount $100 DV56H9100** **any color variation of that model is acceptable. TERMS & CONDITIONS: In order to be eligible for this program, the trade customer agrees to provide sell-through data (point-of-sale data which must include date of sale, consumer name, amount of sale, model sold, and rebate amount) to Samsung or it’s agent in order to substantiate all claims. Eligible models and corresponding reimbursement amount are listed above. SAMSUNG LAUNDRY PAIR REBATE Receive a $100 rebate when you purchase select Samsung® laundry pairs between April 17 - April 26, 2016 by consumers from authorized BrandSource member stores only. Offer good for personal use retail purchases only. This offer is not available to landlords, businesses, dealers or builders. Limit one rebate per household. Additional terms apply, see details below. SA_APR #2 To Be Completed By Salesperson Please Print Sa_0416_B Invoice Number: ______________________________________________ Program ID:______________________________ Sales Person: ______________________________________________ Purchase Date:______________________________ Store Name:_____________________________________________________ AVB ID:______________________________ City:_______________________________________________ State:______ Zip Code:______________________________ Phone Number:_________________________________________ Washer Model Number: ___________________________ Serial Number:_____________________________________ Dryer Model Number: ____________________________ Serial Number:_____________________________________ Expected Rebate: _______________________________ Sa_0416_B To Be Completed By Customer Please Print Customer Name: ______________________________________________________________________________________ Mailing Address: _______________________________________________________________________________________ City:_____________________________________________ State:________ Zip Code:______________________________ Phone Number:____________________________________________ Sa_0416_B Redemption Instructions 1. Mail this fully completed rebate certificate to the address listed below within 30 days of product purchase. 2. Eligible models must be purchased within the dates given for this promotion. (See program details on top of form) 3. Include a legible copy of your sales receipt showing all charges paid, including model number(s) and purchase date. 4. Please allow 12 weeks from May 26, 2016 for delivery of your check. Mail To: Rebate Center Samsung Rebate Sa_0416_B 2121 Natomas Crossings Dr. Suite 200, #304 Sacramento, CA 95834 This offer void where prohibited, taxed or restricted by law. If you do not receive your rebate after 12 weeks of the final postmark date allowed by the program, please visit ‘arrisrebates.com’ to check your rebate status on our website. The customer is solely responsible for lost, mutilated or misdirected mail. If you receive a letter from us requesting additional information, all responses must be made within 4 weeks of our request. This offer is no longer valid if the check is not cashed within 6 months of issue date. By submitting this claim you hereby accept the above stated terms and conditions. This form must be postmarked no later than 30 days of product purchase. Fraudulent submissions may result in federal prosecution.
© Copyright 2026 Paperzz