How many antique/classic vehicles are in your household?

1 2 34 5 or more

What is your age?18 – 25 26 – 3940 – 55 Over 55

Have you used Coker Tire Products before?

No, this is my first timeYes, I have been a customer less than 5 yearsYes, I have been a customer more than 5 years

How did you first hear about thispromotion? (Please check one.)

Direct mail RadioNewspaper TelevisionSalesperson in store WebsiteIn-store display EmailWord of mouth CatalogOther

Which of the following was an important contributing factor in your most recent purchase? (Check all that apply.)

Promotion/saleDealer recommendation Friend/relative recommendation Quality of productActual tires on displayTires in stockOnline research(reviews, websites, etc.) Replacing another set of Whitewalls tires Replacing a different brand of tires

• Purchase tires from Coker Tire or a participating dealer.• Print this form online at cokertire.com/wwrebate and fill it out completely.• Attach original receipt showing the purchase of four new select Whitewall tires within

the offer period.• Mail completed rebate form and original receipt to:

Coker Whitewall Rebate Coker Tire1317 Chestnut StChattanooga, TN 37402

To learn more, call 866-784-2170.Offer valid on purchases made from 12/18/17 - 1/31/18. Form must be received by 2/28/18.

How to receive your $60 rebate:

OPT-OUT

Where did you buy your tires? (Dealer Name)

Date of Purchase Mo. Day Year

Year of Vehicle Make (e.g., Ford) Model (e.g., Mustang)

Email Address

First Name Last Name

Address Apt./Suite Number

City State ZIP Code

Phone

The last four digits of the phone number are required for rebate processing.

What is the next vehicle you plan to purchase tires for?

Year of Vehicle Make (e.g., Ford) Model (e.g., Mustang)

When do you expect to purchase tires for this vehicle? (Please check one.)

In the next 30 days 31 to 90 days from now 91 days to 1 year from now More than 1 year from now

$60 REBATE FORMBuy a set of four (4) select Whitewall tires between December 18, 2017 and January 31, 2018, and get a $60 rebate after form submission!*

1) Completed rebate form 2) Original receipt showing purchase of 4 qualifying tiresChecklist for proper rebate submission:

*Offer valid for residents of the United States only who purchase from a participating dealer located in the fifty (50) United States, District of Columbia (“U.S.”) and U.S. Territories (Puerto Rico, Guam and U.S. Virgin Islands). Purchase must be completed between 12/18/2017 and 1/31/2018. Limit of one (1) redemption request per purchase of four (4) new select Whitewalls tires. Limit of three (3) redemptions per household. Must be at least 18 years of age or older at the time of purchase to be eligible. All requests must be postmarked or received on or before 2/28/2018. Please allow four (4) to six (6) weeks for delivery of the $60 rebate via mail. Sales to Original Equipment manufacturers, fleets, wholesalers, business accounts and purchases for resale are not eligible for this promotion. All decisions made by Coker Tire (or its authorized representatives) relating to the validity of any submissions are final and binding. This promotion is subject to all federal, state and local laws and regulations. Coker Tire reserves the right to modify or discontinue this offer, products and/or services at any time for any reason. No cash refunds. Please retain copies of the materials you submit. All requests become the property of Coker Tire and will not be returned. Coker Tire is not responsible for any lost, late, stolen, damaged, misdirected, incomplete, incorrect or illegible mail. No postage-due requests. For questions regarding this promotion, please call 866-784-2170 Monday through Friday between 8:00 a.m. and 8:00 p.m. ET. Offer may not be assigned, traded, sold or combined with any other Coker Tire offer. THIS OFFER IS NOT VALID WHERE PROHIBITED OR RESTRICTED BY LAW.Copyright © 2017 Coker Tire. All rights reserved.

I do not want email notifications about special offers and promotions from Coker Tire.Coker Tire has a very strict privacy policy. We do not sell or rent your personally identifiable information to third parties.

Rebate applies to these item numbers: 506245066550667506705068750700509005100551035510405105051100

511055120251270513105132051380513855173051760518005200052360

523705240052620531005330053850538555390054100542505425554285

543005450054610546205466754701548205545055460554805548155500

556005566455673556755570056020561005644056700571005730057500

*See additional rebate items numbers on the back.

5762057630576405770057965579975800058200584005857058800591505920059400596006020060400605506055460600608006097061400616006180061991619936199562000620056201062239622436224562247628006280362855628576285862861

6287062880629006295062975632846328563375634006352063523643096440065500664006766068250687757090571385721617257072572725837258572823728257300074172742607444474448744497551575540755707722077226772607726277600

7897279285810008172582500829008330084200502957506535506540506542506543506544506545506546506550506553512076512875512877517810526055526060530285530286530294530295530296530297530299530300530303530310530350538900538904546080546090547010555755

555765555776555780556658556660566050566052566053568745568760568805568810568815568820579028579400579403579605579678579680579760579764579785579787579788579800579810579811579813579814579816579817579834579844579855579885579890587030587031587050587110

597020597050597060613097613117613118613120613122613129619905623048623054629600629700629703629708629710629770629772629970629973629990630600633505635965639755643510643520663515663520676460682310688965688970700200700202700205700210700215700219700300

7003017003027003037003047003057003067003077003087006107080107080207090617090637139107139207139607296107463617463637479557552107615107759807896907898017898035065389579765557978776764302676431167643216764338676434168785106880832

$60 REBATE FORMBuy a set of four (4) select Whitewall tires between December 18, 2017 andJanuary 31, 2018, and get a $60 rebate after form submission!*

Continued rebate item numbers that apply: