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Name Street Address City State ZIP Daytime Phone Evening Phone Participating Retailer Name Circle Qualifying Rebate Amount $ 5 $ 10 OFFICIAL REBATE FORM To receive your rebate: 1. Buy $25 worth of Kimberly-Clark brands to receive a $5 rebate, or buy $35 worth of Kimberly-Clark brands to receive a $10 rebate between 5/1/16 and 8/31/16 in one shopping trip. † 2. Complete this form and mail it in with your original cash register receipt with qualifying purchases circled. 3. Mail your completed form and original cash register receipt by 9/30/16 to: Kimberly-Clark Broker Rebate May-August 2016 Dept. 38658 | P.O. Box 6002 | Douglas, AZ 85655-6002 4. Look for your rebate in your mailbox 8–10 weeks from 10/15/16. Get $ 5 back when you purchase $25 Get $ 10 back when you purchase $35 worth of participating Kimberly-Clark brands! } Customer service phone number: 1-877-391-5275 Monday–Friday, 8:00AM–5:00PM CST Participating brands: HUGGIES ® Products, PULL-UPS ® Training Pants, KLEENEX ® Facial Tissue, GOODNITES ® Bedtime Pants, KLEENEX ® Hand Towels, COTTONELLE ® Products, SCOTT ® Products, VIVA ® Towels, DEPEND ® Products, POISE ® Products and U by Kotex ® Products. For participating retailers, visit KCbrokerrebate.com/May-August2016 For a full list of participating retailers, visit KCbrokerrebate.com/May-August2016 †Offer good only on qualifying purchases made between 5/1/16 and 8/31/16 at participating retailers. Product must be purchased at a participating retailer in one shopping visit. Circle your purchases of any of the Kimberly-Clark Brands listed that total $25 or $35 on your original receipt. Place the original receipt and original rebate form in an envelope and mail with the correct amount of postage to: Kimberly-Clark Broker Rebate May-August 2016, Dept. 38658 P.O. Box 6002, Douglas, AZ 85655-6002. Please retain a copy for your records. Envelopes must be postmarked by 9/30/16 and received by 10/15/16. Limit one (1) rebate form per household or address. Purchases must be made in one transaction. Please allow 8 to 10 weeks for delivery from 10/15/16. Copies of official rebate form or cash register receipt will not be accepted and will not be returned. Rebate offer requests are not redeemable in store. Neither retailers nor the participating brands are responsible for non-complying order forms, lost, late, misdirected, illegible, postage-due or undeliverable mail. Requests from P.O. Boxes, organizations or clubs will not be honored or returned. Requests that in Kimberly-Clark’s sole discretion do not comply with terms and conditions of offer, including fraudulent requests, are invalid. Void where taxed, prohibited or restricted. Offer good only in the United States. Participating retailer list will be available at www.KCbrokerrebate.com/May-August2016. ®Registered Trademark and *Trademark of Kimberly-Clark Worldwide, Inc. ©KCWW. ©Disney. ©Disney/Pixar. Based on the “Winnie the Pooh” works by A.A. Milne and E.H. Shepard.
