Dealer rebates

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Dealer Information

Dealer name

City

State

Customer Information

Customer first name

Customer last name

Customer facility/business name

Mailing address

City

State

ZIP code

Phone #

Product Information

Product purchased Equis Complete (4341) Equis Complete Horse Cubes (2400) Equis Daily 35% (4714) Equis Element (4339) Equis Generation (4340) Equis Golden Senior (4732) Equis Performance (4337) Equis Rice Bran (2785) Equis Teff Natural (4685) Equis Ultramin Mineral (2434) Equis Ultramin Block (8058)

Date of purchase

Tons purchased

Upload receipt/invoice

Drop files here or

Upload media

File name cannot include the following special characters " * : < > ? / \ |
Max file 200MB size per form. Larger file sizes take longer to upload. Acceptable file formats include: .pdf, .jpg, .gif, .doc, .docx, .xls, .xlsx, .mov, .avi, .mp4, .mp3.

Please do not submit the form or close the window until files are fully uploaded which is indicated by a green checkmark next to the file name.

Once submitted, you (the dealer) should expect to receive a credit memo verifying the credit was issued within 2-3 weeks.

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