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For a receipt WE MUST HAVE A COPY OF THE SHIP CONFIRMATION E-MAIL OR ORDER STATUS RECEIPT IN ORDER TO PROCESS YOUR REBATE REQUEST. Please fill in the blanks below. E-COMMERCE PURCHASE LOCATION # 847 ITEM #: ITEM #: ORDER #: ORDER DATE: NAME: ADDRESS: CITY, STATE, ZIP: MEMBERSHIP #: This number is located on the back of your Costco Membership card and starts with a 1, 8 or 3 EMAIL ADDRESS: (optional) TELEPHONE: (optional) Please mail this mail-in rebate submission form, the Ship...
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