©2020 General Motors. All rights reserved.
If you have not received your Visa Prepaid Card within 6 to 8 weeks of your qualified submission, or if you have
questions about your submission, you may visit gmpartsrebates.com or call 866.713.7284 weekdays, 7 a.m. to 7 p.m.
Central time.
General Motors reserves the right to alter or modify this program at any time with no prior notice.
General Motors reserves the right to reject claims it deems to be invalid at its sole discretion.
Rebate Terms:
Offer valid for retail customers with mailing addresses in the United States and U.S. territories who make the purchase in the United States and U.S.
territories. To receive the mail-in rebate debit card, qualifying purchases must satisfy the rebate requirements as outlined on this rebate application.
Failure to meet the mail-in rebate requirements will disqualify your rebate. This offer is not valid on products being replaced under warranty. Fleet
and commercial customers and GM company vehicles are not eligible for this offer. This offer cannot be combined with other General Motors offers.
Limit two (2) redemptions per household and redemptions cannot be assigned or transferred. This offer is void where taxed, restricted, or prohibited
by law. General Motors and its partners are not responsible for lost, late, damaged, illegible, misdirected, or postage-due submissions. Any excessive
submissions, misrepresentation, or fraudulent information disqualifies the rebate and may give rise to criminal or civil prosecution. All rebates shall be
governed by applicable state and federal laws. All terms, conditions, and rules of this program are subject to change. All submitted materials become
the property of General Motors and will not be returned. Rebate paid in the form of a Visa Prepaid Card. General Motors reserves the right to substitute
a check of equal value in lieu of a Visa Prepaid Card at its discretion. Card is issued by MetaBank®, Member FDIC, pursuant to a license from Visa U.S.A.
Inc. No cash access or recurring payments. Can be used everywhere Visa debit cards are accepted. Card valid for up to 6 months; unused funds will
forfeit after the valid through date. Card terms and conditions apply. Please allow up to 6 to 8 weeks for delivery of the rebate.
General Motors reserves the right to alter or modify this program at any time with no prior notice.
General Motors reserves the right to reject claims it deems to be invalid at its sole discretion.
on the purchase of an ACDelco Engine Air
Filter wherever ACDelco parts are sold
$
5
MAIL-IN
REBATE
AM-FM-0761-19E
LIMIT 2 PER
HOUSEHOLD
Consumer Information Section (
*
Indicates Required Field)
*First Name: _____________________________________ *Last Name: ______________________________________________
*Address: ____________________________________________________________________________________________________
*City: __________________________________________________________________ *State: _____________ *ZIP: _______________
*Email: _____________________________________ @ ____________________ *Phone: ( _______ ) _______ – _______________
*Purchase Location Name: __________________________________________________________________________________
(!) IMPORTANT: Photocopy your entire submission for your records. You may be required to mail or fax these photocopies.
To receive your General Motors Parts Visa
®
Prepaid Card by mail, follow these conditions of acceptance:
1. Purchase an ACDelco Engine Air Filter between 1/1/2020 and 6/30/2020 wherever ACDelco parts are sold.
2. To submit online: Submit your rebate online for easier processing. Using a computer, tablet, or mobile phone, go to
gmpartsrebates.com. Select “Vehicle Owner” on the homepage. Then, select “Get Started” under the GM Genuine
Parts/ACDelco logo on the left. Select the Engine Air Filter Rebate Offer and follow the prompts to complete your
submission. You will be required to upload a copy of your dated receipt from a retailer or paid repair order from a
professional installer with part number detail included. (Must be submitted by July 31, 2020.)
3. To submit via mail: Complete all information requested on this form accurately and legibly. Enclose original or a
copy of the original dated paid repair order. Mail all documents to: ACDelco Engine Air Filter Rebate Offer
(#2020027), P.O. Box 341835, Bartlett, TN 38184. (Submission must be postmarked by July 31, 2020.)
By providing my contact information, I consent that ACDelco and/or GM can contact me with any GM offers and GM product
information. For more information on the GM Privacy Statement, call 1.866.MY.PRIVACY (1.866.697.7482),
or visit gm.com/privacy.
