Mail in this claim form to receive your rebate.†
To qualify, you must purchase a set of four Michelin high-performance tires ®
from a participating Michelin retailer between April 17 and May 20, 2006.
Please print legibly
First name* Last name*
Postal code* - Daytime telephone ( ) -
Name of retailer Date of purchase
day - month - year - -
† The federal and provincial tax will be calculated on the selling price before the rebate. / * Required information
1. Is this the first time you have purchased Michelin® tires? 3. Did this promotion influence your selection of Michelin® tires versus a competitive product? Yes No
4. Which listed attribute(s) most influenced your decision to buy Michelin® tires? (Please check up to three)
2. How did you find out about this promotion? Quality product Safety/security Driving exhilaration Reputation
Radio Television In store Newspaper Internet Friend/family Rebate offer Recommended by sales person
I do not authorize Michelin to send me information concerning contests, promotions and new products.
Pilot® Sport Cup Pilot® Primacy™ 4x4 Synchrone®
Pilot® Sport PS2™ Pilot® HX MXM® 4x4 Diamaris®
Pilot® Sport Pilot® HX MXM4® Pilot® LTX™
Pilot® Sport A/S Pilot® MXX3™ Latitude® Tour HP
Pilot® Exalto® A/S Energy® MXV4® Plus/S8 4x4 XPC™
Pilot® Exalto® PE2™ Cross Terrain® SUV H-rated Pilot® Preceda
Pilot® XGT® V4 LTX™ M/S H-rated Energy® E3A
Pilot® XGT® Z4 LTX™ A/S H-rated
Please send me the following rebate: Rebate claims must be received by July 3, 2006,
$100 rebate on a set of 4 ZR-rated tires at the following address:
$75 rebate on a set of 4 V-rated tires Michelin Coupon Redemption Centre,
$60 rebate on a set of 4 H-rated tires 219 8th Avenue, Ile Perrot, Qc, J7V 4T2
NOTE: To obtain your rebate please send in the original claim form and a copy of the detailed invoice* clearly indicating the purchase of four Michelin® high-performance tires
(purchased between April 17 and May 20, 2006).
Ask your participating authorized Michelin® retailer or visit www.michelin.ca for details. This offer cannot be combined with any other Michelin® promotion or program. Retail sales only. Offer valid only in Canada
from April 17 to May 20, 2006. Purchases outside these dates will not be honoured. Please allow 4-6 weeks to receive your rebate.
*Estimates, work orders or quotations are not acceptable as proof of purchase. For any information regarding the rebate, please call 1-866-425-1331 or visit www.michelinpromo.com