Remittance Form

  • (Refer to the settlement email for your Organization Code.)
  • Please type the name of your Organization exactly as it should appear on your rebate check so your treasurer will be able to deposit it.
  • Please type the full Name and Mailing Address for the location where we will mail your rebate check.
  • IMPORTANT NOTE: Please give careful consideration to who opens the mail at the address you provide and be sure they know what to do with the check! A $25 processing fee is charged to replace a rebate check.
  • Checks expire after 90 days.