Smothers European Volvo

To receive your reimbursement Check or Cash Card, please complete this form, attach it to a

copy of your original Volvo receipt and mail to:

C/O ACB, P.O. Box 1919, Memphis, TN 38101

*Please check one. If no box is checked, a Cash Card will be sent.

Accessories must be purchased between May 1, 2011 and September 30, 2011.

Log on to www.acbrebate.com/volvorebates to check the status of your reimbursement.

Offer valid at participating authorized Volvo Retailers only. Proof of purchase required. Cannot be combined with any other offer.

Offer void where prohibited by law. Request must be postmarked by October 31, 2011. Please allow 6-8 weeks for reimbursement.

To be completed by Customer:

First Name: ______________________________ Last Name: ______________________________

Street Address: ___________________________________________________________________

City: ____________________________________ State: ________ Zip Code: __________________

Daytime Phone: ___________________________________________________________________

To receive product information and special offers from Volvo via e-mail, please provide your e-mail

address below or register your Volvo online through the "Your Volvo" tab on volvocars.us.

E-Mail: ___________________________________________________________________________

We do not provide personal information about you to unrelated companies for their independent use. We do not sell, trade or disclose your

contact information to independent third parties for their independent use without your permission.

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©2011 Volvo Cars of North America, LLC. The Iron Mark and "Volvo Service for Life" logos are registered trademarks of Volvo.

(set of 4) . . . . . . . . . . . . . . $200

(Front or Rear) . . . . . . . . . . $50

Running Boards . . . . . . . . $40

View Camera . . . . . . . . . . . . $35

Entertainment . . . . . . . . . . . $35

Vertical Divider . . . . . . . . . . $35

Sailboard Carrier . . . . . . . . .$10

(Check all that apply.)

Ask your Volvo retailer for

more information about the

accessories listed or visit

volvocars.us