BRIDGESTONE BLIZZAK WINTER TIRE...

_______________________________________________________________________________________First Name Please Print Clearly Last Name

_______________________________________________________________________________________Mailing Address

_______________________________________________________________________________________City State Zip Code

_______________________________________________________________________________________Email Address (REQUIRED FOR COMMUNICATION)

(______) _________________________ Receipt/Invoice Date: ____/_____/2014Mobile Phone Month Day

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I had my new set of 4 eligible Bridgestonetires mounted on the following vehicle:

_______________________________________________________________________________________Year Make Model

I have read and complied with all the TERMS AND CONDITIONS. Enclosed is my store-identi� ed receipt/invoice(s) indicating an eligible tire purchase, proof of mounting, and this original claim form. I hereby con� rm that all information herein is valid and correct.

X _____________________________________________________________________________________PURCHASER’S SIGNATURE REQUIRED

OFFICIAL CLAIM FORM

BRIDGESTONE BLIZZAK WINTER TIRE PROMOTION

File Your Reward Claim Online At BRIDGESTONEREWARDS.COM OR Mail In (see details below):

• Purchase between Sept. 15–Nov. 30, 2014 • Submit this request NO LATER than Dec. 10, 2014• Purchase and install a set of 4 eligible tires

• Please indicate below which tires were purchased

BRIDGESTONE BLIZZAK WINTER TIRE PROMOTION TERMS AND CONDITIONS

1. Enclose your store-identi� ed, dated, ORIGINAL � nal paid receipt/invoice(s), with your name, dealer name, date of purchase showing eligible tire purchase, price paid and proof of mounting with this completed claim form. Circle the tire purchase on your receipt/invoice. If more than one Reward Card is requested, documentation MUST be submitted for each eligible purchase. PHOTOCOPIES WILL NOT BE ACCEPTED. Limit two reward claims per customer/address/household or email.

2. Name on claim form and on receipt/invoice(s) MUST be the same. Additional claims for same customer or household must include additional claim form(s) and additional original receipt/invoice(s) showing purchase of additional set(s) of 4 tires for different vehicle(s). If a company name appears on receipt/invoice(s), please provide the � rst and last name of the authorized Card user. This offer is for retail purchasers only and excludes Commercial, Fleet and group purchases along with employee changeovers or warranty replacement purchases.

3. Offer valid to purchasers who are residents of Alaska. Void where prohibited, taxed or restricted. Must be 18 or over.

4. Receipts/invoices and submissions that are altered, forged, illegible, incomplete or defaced in any way are invalid and will automatically be deemed ineligible. Fraudulent submissions may result in prosecution under the U.S. Mail Fraud Statute (18 USC Sections 1341-1342).

5. Bridgestone Americas Tire Operations, LLC does not share, sell, or otherwise distribute customer information to third parties. The information collected herein is solely used by Bridgestone for marketing purposes and for the administration of the program.

6. Neither Bridgestone Americas Tire Operations, LLC nor Bridgestone Program Headquarters or claim form processor are responsible for late, lost, illegible, postage due or misdirected mail, online claims that are corrupted, inaccessible, garbled or otherwise defective, or online claims not received due to electronic, programming, internet or at any website. Bridgestone Americas Tire Operations,

LLC reserves the right to cease making the claim form available online due to electronic, programming or technological problems/malfunctions/failures of any kind. Please make copies of your submission as original materials become the property of Bridgestone and will not be returned to customer.

7. All decisions made by Bridgestone Americas Tire Operations, LLC and Bridgestone Program Headquarters are � nal. For inquiries after 4 weeks, contact our toll-free number: 855-707-7554.

8. Prepaid card is issued by MetaBank®, Member FDIC, pursuant to a license from Visa U.S.A. Inc. The prepaid card is given to you as a reward, and no consideration, value, or money has been paid by you in exchange for the reward card. Card does not have cash access and can be used at any merchants that accept Visa debit cards. Card valid for up to 6 months, fees may apply, see the terms that accompany your card for details regarding funds after card expiration. Card is not transferable and cannot be issued to minors. Country restrictions apply and are subject to change. Card terms, conditions and limitations apply; see MyPrepaidCenter.com/site/Bridgestone for details.

Customers that � le online do not need to mail in claim form.

OFFER EXCLUDES ALL OTHER BRIDGESTONE TIRES AND COSTCO DEALERSHIP PURCHASES. Promotion will be ful� lled with a Bridgestone Visa Prepaid Card8. Only one reward shall be issued for each set of 4 eligible tires. Visa prepaid card may be used anywhere Visa debit cards are accepted in the U.S. Certain limitations apply. See Cardholder Agreement. Not redeemable for cash. Please allow 10 to 12 weeks for the receipt of the prepaid card or gift card. Visit BridgestoneRewards.com to check the status of your claim or to contact us.

ALL CLAIM FORMS MUST BE FILED ONLINE OR POSTMARKED BY DECEMBER 10, 2014. FILE ONLINE AT BRIDGESTONEREWARDS.COM OR MAIL BY DECEMBER 10, 2014; IF MAILED, RECEIPT BY DECEMBER 19, 2014. MAIL TO:BRIDGESTONE OFFER CTCFLAK2014PO BOX 130008EL PASO, TEXAS 88153

REWARD: OFFER CTCFLAK2014

Blizzak™ DM-V1 Blizzak™ DM-Z3 Blizzak™ LM-25 RFT Blizzak™ LM-25 4x4 Blizzak™ LM-32 Blizzak™ LM-32 RFT Blizzak™ LM-50 RFT Blizzak™ LM-60

Blizzak™ LM-60 RFT Blizzak™ LM-80 RFT Blizzak™ MZ-03 RFT Blizzak™ W965 Blizzak™ WS60 Blizzak™ WS70 Blizzak™ WS80

I purchased a set of the following eligible Bridgestone tires:

Thank you for choosing Bridgestone Blizzak™ tires. Please see below for terms and conditions of offer.

Reward: $70 Bridgestone Visa® Prepaid Card

ORIGINAL FINAL PAID RECEIPT/INVOICEmust be submitted with this claim form.

Promotion will be paid with a Bridgestone Visa Prepaid Card.

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12/13 JOHN SMITH THANK YOU

VALIDTHRU

DEBIT

AWARD