Order Number A20522 $100 rebate Rebate Amount SKU Number MAIL TO: ActiveForever 10799 N. 90th Street Scottsdale, AZ 85260 Note: Envelope must be postmarked by 12/31/14. Be sure to make a copy of all materials of the rebate submission(s) for your records. Toll-Free Customer Service Line: 800-377-8033 (Optional) Please check here if you do not wish to receive promotional emails. We do not sell or distribute our list OFFER VALID FOR PURCHASE DATES: 07/01/14 - 12/31/14 Mail this completed form, a clear copy of the receipt, and the physical product number barcode. Photocopies of the product number barcode are acceptable. Mailing envelopes must be postmarked by 12/31/14. Manufacturer is not responsible for lost or misdirected mail. OFFER VALID FOR ACTIVEFOREVER.COM ONLY FOR PURCHASE DATES: 07/01/14 - 12/31/14. Limit one rebate per person, household, family or address. End users only, no dealers or resellers. Must include physical address, no P.O. Boxes are accepted. Incomplete rebate coupons will be denied. Use of fictitious names, multiple addresses, or PO Boxes to obtain additional rebates may constitute fraud, violate Federal law and may result in prosecution, term of imprisonment and/or fine. Rebate rights cannot be transferred and void where taxed, restricted or prohibited by law. This offer may not be published in any publication without written permission of ActiveForever. This rebate cannot be combined with other offers from ActiveForever. Rain checks will not be honored. Offer good for customers in United States of America only. Please allow 8-10 weeks for the rebate check. In order to receive your rebate from ActiveForever you must purchase the following eligible products listed below between 07/01/14 - 12/31/14. Additionally, the materials and information listed below are required prior to rebate payment. Failure to submit any of the following items will delay or prevent rebate payment. Enclose the following: 1. A clean, clear copy of the receipt, the eligible product number and purchase date. 2. This completed coupon or a copy of this coupon. 3. Cut and submit the physical barcode with UPC barcode number listed from product packaging. (Photocopies of UPC are acceptable) SAMPLE UPC BARCODE active forever IMPROVING OUTCOMES. IMPROVING LIVES. ™

active forever · Scottsdale, AZ 85260 Note: Envelope must be postmarked by 12/31/14. Be sure to make a copy of all materials of the rebate submission(s) for your records. Toll-Free

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Page 1: active forever · Scottsdale, AZ 85260 Note: Envelope must be postmarked by 12/31/14. Be sure to make a copy of all materials of the rebate submission(s) for your records. Toll-Free

Order Number

A20522 $100 rebate

Rebate AmountSKU Number

MAIL TO:

ActiveForever10799 N. 90th StreetScottsdale, AZ 85260

Note: Envelope must be postmarked by 12/31/14. Be sure to make a copy of all materials of the rebate submission(s) for your records. Toll-Free Customer Service Line: 800-377-8033

(Optional)

Please check here if you do not wish to receive promotional emails. We do not sell or distribute our list

OFFER VALID FOR PURCHASE DATES: 07/01/14 - 12/31/14Mail this completed form, a clear copy of the receipt, and the physical product number barcode. Photocopies of the product number barcode are acceptable. Mailing envelopes must be postmarked by 12/31/14. Manufacturer is not responsible for lost or misdirected mail. OFFER VALID FOR ACTIVEFOREVER.COM ONLY FOR PURCHASE DATES: 07/01/14 - 12/31/14. Limit one rebate per person, household, family or address. End users only, no dealers or resellers. Must include physical address, no P.O. Boxes are accepted. Incomplete rebate coupons will be denied. Use of fictitious names, multiple addresses, or PO Boxes to obtain additional rebates may constitute fraud, violate Federal law and may result in prosecution, term of imprisonment and/or fine. Rebate rights cannot be transferred and void where taxed, restricted or prohibited by law. This offer may not be published in any publication without written permission of ActiveForever. This rebate cannot be combined with other offers from ActiveForever. Rain checks will not be honored. Offer good for customers in United States of America only. Please allow 8-10 weeks for the rebate check.

In order to receive your rebate from ActiveForever you must purchase the following eligible products listed below between 07/01/14 - 12/31/14. Additionally, the materials and information listed below are required prior to rebate payment. Failure to submit any of the following items will delay or prevent rebate payment.

Enclose the following:

1. A clean, clear copy of the receipt, the eligible product number and purchase date.

2. This completed coupon or a copy of this coupon.

3. Cut and submit the physical barcode with UPC barcode number listed from product packaging. (Photocopies of UPC are acceptable)

SAMPLE UPC BARCODE

active foreverI M P R O V I N G O U T C O M E S. I M P R O V I N G L I V E S.

™