PAKP4_051108 - circuitcity.com

or

Rebate sample report                         OFFER REDEMPTION FORM

        $50 CC MIR for LOG 9701750403

                                Program ID: PAKP4
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Please completely fill out the form below and make a copy for your
records.

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QUALIFYING MODELS:
Mail-in Offer on Purchase of:

LOG 9701750403 Qty: 1 Offer Amount: $50.00

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Please see your sales associate regarding qualifying models or for
additional information.

Qualifying items must have been purchased between
                5/11/2008 and 5/17/2008

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HOW TO SUBMIT FOR THIS OFFER:

Please send in the following items:

* This form in its entirety.
* A Copy of the UPC barcodes from the product packaging.
* A Legible Copy of the Circuit City sales receipt or confirmation e-mail from circuitcity.com.
* Please circle the qualified item(s) and purchase price(s) on your Circuit City sales receipt or confirmation e-mail.

* See our website information below for details.* Please circle the qualified item(s) and purchase price(s) on your Circuit City sales receipt or confirmation e-mail.

The above listed items must have been purchased during the listed
sales dates. Forms postmarked later than 6/16/2008 are ineligible.
By submitting this form, you certify that the above items are for
personal use only and not for resale. Allow 8 weeks from postmark
date for processing of your rebate or other promotional offer. This
offer is valid for customer name on sales receipt only. Circuit City
and its associated companies are not responsible for lost or misdirected
mail. This form and sales receipt will not be returned.

Offer void where prohibited or restricted by law. Fraudulent
submission of multiple requests may result in prosecution under
applicable law. Circuit City and its associated companies reserve the
right to audit any claims, to request additional information regarding
this claim and to nullify any claims which cannot be substantiated.
Please see your sales associate regarding qualifying models or for
additional information. Products for which rebate or promotional offer
is claimed may not be returned.

Advertised rebate amount assumes payment of Circuit City's before-rebate
advertised price. Circuit City reserves the right to reduce the fulfilled
rebate amount based on price adjustments and/or price matches made on
qualifying items.

- Offer valid in USA only.

Additional Terms and Conditions for promotional Incentive Check Offers
Sponsored by Circuit City (Excludes all Manufacturer Rebates):

If your submission has a timely postmark but you have not provided all
required documentation, Circuit City will allow you 6 months from the
postmark date to remedy any deficiencies to Circuit City's satisfaction.
If you do so, Circuit City shall then mail you a promotional incentive
offer check within 8 weeks.

In order to accept this offer, you must cash the promotional incentive
offer check within ninety (90) days of check issuance. If you do not
cash the check within this time period, you shall be deemed to have
rejected this offer, making it void. Circuit City is not responsible
for any lost or misdirected checks. By submitting this form, you
acknowledge and agree to these conditions of acceptance and that any
disputes arising from or relating to this offer will be governed by
Virginia law without regard to its choice of law rules.

Limit 1 rebate(s) or other promotional offer(s)
per customer

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CUSTOMER INFORMATION:

Please verify name, address, and phone number below.
Name:___________________________________________________
Address:________________________________________________
City_____________________State:_________Zip Code:_______
Home Phone:_____________________________________________

Email Address:_____________________________________

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MAIL THIS FORM IN ITS ENTIRETY TO:
Circuit City #PAKP4
P.O. Box 540040
El Paso, TX 88554-0040

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To track the real-time status of your claim, please visit our website.

www.ccityrebates.com

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        If you have questions about your offer, please call
                        866-754-7717
                Business hours may vary.
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