12/29/13 Print Form

https://asus.4myrebate.com/Document/RebateHTMLReceipt?TrackingNo=2231141116951010&zipcode=11777&TrackwithFenixPriority=True 1/1

Tracking Number: 2231141116951010

Print and Sign Your Rebate FormMail Rebate To: (must matchbilling addresson invoice orpacking slip)

Sergio Rescia515-9 HIGH STAPT 09Belle Terre, NY 11777(631) 344-4232sergio.rescia@gmail.com

Offer Code: ASU-11862

Item:(Qty: 1) ASUS RT-N12/D1 WirelessNetworking

Offer Maximum: 2 claim(s) per household

Starts: 11 / 30 / 2013

Expires: 12 / 06 / 2013

Must be postmarkedwithin:

30 Days of purchase

Reseller: Newegg.com

Rebate Amount: $20.00

The American Express ® Reward Card : $20.00

I have read and agree to the terms of the rebate as described on the asus.4myrebate.com website.

Signature: __________________________________________________ Date:________________

YOU MUST SIGN AND MAIL IN THIS FORM AND THE DOCUMENTATION REQUIRED TO RECEIVE YOUR REBATE

Mail In Rebate Form

Mailing Instructions:

1. Print this form Please print and mail this form to us.

2. Enclose all documents Attach all the required proof of purchase documentation to this rebate form and placeeverything in a mailing envelope.

3. Mail itAttach the label displayed below to yourenvelope. Envelopes without a proper label maynot be delivered and processed.

4. This Submission Requires (please be sure to include all necessarydocumentation):

Signed Rebate Form

Copy of Receipt/Invoice or Packing List

Original UPC/Serial Number Barcode Label

5. ConfirmationA confirmation email that includes your tracking number for this rebatehas been sent to the email address you provided. You will receiveadditional updates as your rebate status changes. Please allow 1 to 2weeks after mailing your rebate application to receive an update to yourstatus.

Please locate the (Proof of Purchase) barcode label onyour product box or shipping box similar to the onebelow. Cut out the barcode label and attach to form.

SAMPLE IMAGE, Notthe actual size

IMPORTANT - Envelopes without a properlabel may not be delivered and processed.

Rebate ProcessingOffer #: ASU-11862 P.O. BOX 130018EL Paso, TX 88513-0018