_________________________, 20_____ (Date of Letter) ______________________________ (Name of Company) ______________________________ (Attn: Rebate Department) ______________________________ (Street Address) ______________________________ (City, State and Zip Code) RE: _________________________________________ (Rebate Request) Dear Rebate Clerk: Enclosed please find your company's coupons, which are hereby submitted pursuant to instructions for company rebate on the product purchase of _____________________________________________________ (name of product purchased). The product was purchased from ______________________________ (name of store) on the _____ day of _________________, _____(year). The enclosed coupons indicate a rebate of $_______________ for the purchase of this product. Please forward the rebate and provide available information regarding additional product benefits. Thank you. Very truly yours, ______________________________ (Signature) ______________________________ (Address) ______________________________ (City, State and Zip Code) ______________________________ (Phone Number) LAWCHEK, LTD. LETTER PRO Samples, Copyright 2006 This is not a substitute for legal advice. An attorney must be consulted.