1. Purchase any Delta^® kitchen or bath faucet between April 1, 2006 and March 31, 2007.

2. Send the following:

• This original completed claim form (no duplicates accepted.)
• This original form can be used for up to three $10 rebates per household.
• Cash register receipt(s) with Delta^® item(s) and dollar amount(s) circled.
• Carefully cut the UPC code from each faucet carton and include it with this claim form.

MAIL TO:

Delta Faucet
P.O. Box 11485
South Bend, IN 46634-0485

3. Receive your rebate check by mail.

Offer expires March 31, 2007. Rebate claims must be postmarked by April 30, 2007. Limit three rebates per household. Void where prohibited, taxed or restricted. Reproduction, sale, trade or purchase of this certificate, cash register receipt, or UPC is prohibited. Please allow 6-8 weeks for processing. Offer good only in USA. Fraudulent submission could result in federal prosecution under US mail fraud statutes. Delta Faucet is not responsible for late, lost, misdirected, illegible, incomplete, indiscernible or postage-due submissions.

Rebate Hotline: 1-866-293-7486

First Name:

Last Name:

Address:

City:

State: ZIP:

Phone:

E-mail:

Store where purchased:

Model number:
Model number:
Model number:

Would you like to receive more information about Delta^® or Peerless^® faucets in the future?

Yes        No

What brand of faucet are you replacing?