2019 VV Rebate Form


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I purchased one-pound bottles at a $5 rebate per each for a total rebate of $.
I purchased four-pound bottles at a $10 rebate per each for a total rebate of $.
I purchased eight-pound bottles at a $20 rebate per each for a total rebate of $.
This comes up to a total of $ in rebates (max rebate is $100).