October 28, 2019 – November 24, 2019

PEP BOYS VISA® PREPAID CARD

REBATE CLAIM FORM
(CANNOT BE COMBINED WITH ANY OTHER OFFER)

Please Print Clearly: CONDITIONS OF ACCEPTANCE:

To be legally entitled to receive the rebate payment, you must:
1. Purchase any of the listed products at a Pep Boys store
Name between October 28, 2019 – November 24, 2019.
2. Circle the qualifying items on the REGISTER RECEIPT or INVOICE
(We cannot accept a Work Order).
Address 3. Complete, sign and date this form. To be eligible for this offer, you
must indicate the Quantity Purchased and Rebate Total for all
selected items within this form. Ensure all requested information is
City State ZIP filled in accurately, legibly and completely.
4. Submit:
Online at: http://www.pepboys.com/rebates (allow one day after
purchase before submitting online) OR Mail to address below -- be
Phone ( ) sure to include a completed and signed Claim Form AND your Pep
Boys REGISTER RECEIPT or INVOICE (NOT the work order).
5. Requests must be submitted or postmarked within thirty (30) days
E-mail from date of purchase.
I would like to receive e-mail from Pep Boys on product promotions and other Pep Boys services. 6. Make copies of all rebate submission materials for your records.
Any disputed claim will require photocopy substantiation.
7. Understand and agree that the rebate will be the value of all valid
Signature Must be signed
and dated
rebates on a Pep Boys Visa Prepaid Card issued by MetaBank®,
Please Sign Your Name Here Member FDIC, pursuant to a license from Visa U.S.A Inc.

By completing this rebate request, I accepted and complied, or will

Date comply with all of the Conditions of Acceptance for this rebate offer. Mail to: Get exclusive
Pep Boys November 2019 Rebates online SERVICE,
PBA-191101 PARTS, TIRES and
Submit online at: http://www.pepboys.com/rebates PO Box 750053 ACCESSORY offers
El Paso, TX 88575-0053 at pepboys.com

Terms & Conditions: Offer valid for purchases at Pep Boys locations in the continental United States. Visa Prepaid Cards will be paid in United States dollars only to United States
residents. Rebate Offer cannot be combined with any other offer, rebate or discount. Pep Boys is not responsible for lost, damaged or incomplete Rebate Claim Forms or for
misprints or typo-graphical errors. Offer is void where restricted or prohibited. All federal, state and local taxes are the responsibility of the Rebate recipient. Rebate Limit(s) apply
per product, per person. To receive your Rebate, you must satisfy all the Conditions of Acceptance (above). Failure to comply with any of these Conditions of Acceptance will
result in a rejection of this Rebate Claim Form. Any inquiries concerning disputes or claims of non-payment must be made by 3/14/20 and will require photocopy(s) of receipt(s)
and completed mail-in Rebate Claim Form. Any such disputes will be governed by the laws of the State of Minnesota. Failure to use your Visa Prepaid Card shall void the Rebate
Claim and will relieve Pep Boys of any obligation or liability to pay the rebate. Fraudulent submissions including multiple requests could result in federal prosecution under the U.S.
Mail Fraud Statutes (Title 18, USC 1341 and 1342). This Card is issued by MetaBank, Member FDIC, pursuant to a license from Visa U.S.A Inc. Cards do not have cash access and
can be used anywhere Visa debit cards are accepted. Use of this card constitutes acceptance of the terms and conditions stated in the Cardholder Agreement. Visa Prepaid
Cards expire 120 days after the date of issuance, which date will be shown on the front of each Card. If you have not received your rebate after 8 to 10 weeks, please call
1-888-829-1420, Monday-Friday, 7AM – 7PM CST or check your rebate status at: http://www.pepboys.com/rebates/.

ACCESSORIES / LIGHTING OIL

Product Rebate Amount Rebate Limit Item Qty. Rebate Total Product Rebate Amount Rebate Limit Item Qty. Rebate Total
Shelter Logic 10' x 20' Carport Canopy (#25757) $30.00 1 5-qt. container of Valvoline Modern Engine Full Synthetic $10.00 2
Shelter Logic 10'x20' Carport Canopy (#62680) $30.00 1 Motor Oil (various #'s)
Philips Vision Twin Pack Headlamps (various #'s) $7.00 2 5-qt. Container of Castrol Edge Synthetic Motor Oil $15.00 2
Phillips VisionPlus Twin Pack Headlamps (various #'s) $10.00 2 (various #'s)
Phillips Crystal Vision Ultra Twin Pack Headlamps $15.00 2 5-qt. Container of Castrol Edge Synthetic High-Mileage $15.00 2
(various #'s) Motor Oil (various #'s)
Philips Xtreme Vision Twin Pack Headlamps (various #'s) $15.00 2 5-qt. Container of Pennzoil Platinum Synthetic Motor Oil $15.00 2
(various #'s)
ANTIFREEZE / COOLANT 5-qt. Container of Pennzoil Platinum Synthetic $15.00 2
Product Rebate Amount Rebate Limit Item Qty. Rebate Total
High-Mileage Motor Oil (various #'s)
Peak Long Life FS Antifreeze (#PRA003) $6.00 4
5-qt. Container of Valvoline Synthetic Motor Oil (various $15.00 2
Peak Long Life 50/50 Antifreeze (#PRA053) $6.00 4
#'s)
Peak 10X 50/50 Antifreeze, Gal. (#PKPB53) $6.00 4
5-qt. Container of Valvoline Synthetic High-Mileage $15.00 2
Peak 10X Full Strength Antifreeze, Gal. (#PKP0B3) $6.00 4
Motor Oil (various #'s)
BATTERIES 5-qt. Container Mobil 1, Mobil 1 EP or Mobil 1 High $15.00 2
Product Rebate Amount Rebate Limit Item Qty. Rebate Total Mileage Motor Oil (various #'s)
Bosch Premium Batteries (various #'s) $20.00 1
Champion® Batteries (various #'s) $20.00 1
Bosch Platinum AGM Batteries (various #'s) $40.00 1
Champion® AGM Batteries (various #'s) $40.00 1

HEADLIGHT RESTORATION
Product Rebate Amount Rebate Limit Item Qty. Rebate Total
3M Headlight Restoration Kit W/Clear Coat (#39175) $5.00 1

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 October 28, 2019 – November 24, 2019
PEP BOYS VISA® PREPAID CARD
REBATE CLAIM FORM
(CANNOT BE COMBINED WITH ANY OTHER OFFER)

SERVICE WIPERS
Product Rebate Amount Rebate Limit Item Qty. Rebate Total Product Rebate Amount Rebate Limit Item Qty. Rebate Total
Free Hitch Installation with Hitch Purchase $49.99 2 Buy 2 Rain-X Latitude Water Repellency Wiper Blades $10.00 Unlimited
Powerstop Brake Kit Installation (#1325663) (Must $25.00 2 (various #'s) and Get $10 back by mail (Must Buy 2)
Buy PowerStop Brake Kit) Buy 2 Rain-X Silicone AdvantEdge Wiper Blades $15.00 Unlimited
Select Packages Front and/or Rear ProStop Standard $30.00 2 (various #'s) and Get $15 back by mail (Must Buy 2)
Brake Pads/Shoes, ProStop Platinum, Wagner®
Brake Shoe Brake Service
Select Packages Front and/or Rear Wagner® Quick $40.00 2
Stop Brake Service
Select Packages Front and/or Rear ProStop Ceramic, $60.00 2
Bosch Quiet Cast, Wagner® Thermo Quiet®,
Wagner® Severe Duty, Wagner OEx, Ferodo, EBC,
Akebono, Wagner® Severe Duty Brake Service

TOTAL EXPECTED VISA PREPAID CARD AMOUNT:

THANK YOU FOR SHOPPING AT PEP BOYS!

Submit online at: http://www.pepboys.com/rebates

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