About the primary cardmember*: |
Name |
|
Address |
|
City |
|
State |
|
Zip |
|
Email Address(optional) |
|
|
If
you provide an email address, we may use it to contact you about
your account. We may also use your email address to send you information
about products and services you might find useful. |
Citi Driver's Edge Account Number |
|
Amount of rebates you would like to redeem ($25 minimum): |
|
All available. |
|
Another amount. Enter exact amount of rebates you would like to redeem. |
|
$
|
About your vehicle: |
I'm redeeming for (check any that apply): |
|
|
|
Date of Purchase/Lease |
|
Vehicle Identification No.
(VIN° Optional) |
|
Manufacturer |
|
Year |
|
Model |
|
Amount Paid for Vehicle |
|
Please enclose a copy of one of the following as
proof of purchase or lease* (check one): |
|
Dealership Bill of Sale |
|
Lease Agreement |
For Used Car Private Sale: You must send a copy of
the vehicle registration if you purchased your car from a private
party, along with a copy of one of the following as proof of the
amount paid: (1) Cancelled check or bank draft, wire transfer confirmation,
or similar proof of funds transfer, or (2) Bill of sale signed by
the previously registered owner of the vehicle evidencing the amount
paid. |
|
I certify that I have purchased or leased the vehicle
identified above. |
Primary Cardmember Signature |
|
Date |
|
Mail completed form within 90 days of purchase
or lease to:
Citi Driver's Edge Redemption Center
PO BOX 6097
Sioux Falls, SD 57117-6097
|
|
*Citibank reserves the right to request additional information prior
to processing.
You may call 1-800-967-8500
to find out your available Driver's Edge rebates. Any unredeemed
rebates remain in your account.
|
To transfer Driver's Edge rebates: |
If an authorized user or household member, residing at your
address, has purchased an eligible vehicle, you may redeem your rebates for that purchase.
Please note that the redemption check will be made out in the name of the primary cardmember.
|
For redeeming rebates: I certify that |
Name |
|
Relationship |
|
has purchased an eligible vehicle and is an authorized user
of my account or member of my household, and I will be using my rebates to
redeem toward this purchase." |
Primary Cardmember Signature |
|
Date |
|