Other terms and conditions. Requests from groups or organizations will not be honored. Fraudulent submission of multiple requests could result in federal prosecution under the U.S. Mail Fraud Statutes (18 USC, Section 1341 and 1342). Offer good in U.S.A. only. Void where prohibited, taxed or restricted by law. If you do not receive your prepaid card within 6-8 weeks, please call 1- 877- 204 -1223 or visit Lowes.com/Rebates. This certificate may not be reproduced, traded or sold. Please keep a copy of this form for future reference. Samsung Visa Prepaid Cards are issued by MetaBank®, Member FDIC, pursuant to a license from Visa U.S.A. Inc. This card does not have cash access and can be used anywhere Visa debit cards are accepted. Card valid through expiration date shown on front of card. Cardholders are subject to terms and conditions of the card as set forth by the issuing bank.
Check the status of your rebate at Lowes.com/Rebates
Name _________________________________________________________________________________________
Address _______________________________________________________________________________________
City _________________________________________________ State ____________ Zip Code _______________
Mobile Phone ( )_____________________ Email ______________________________________________
1. Purchase three (3) or more qualifying Samsung appliances from a participating Lowe's store between 01/02/2020 and 03/04/2020. Submit all required information via mail-in or online to receive a rebate in the form of a Samsung Visa Prepaid Card by mail. Requests must be postmarked by 04/01/2020.
- Claims postmarked after this date will not be honored.2. Limit one (1) Samsung Visa Prepaid Card per household.3. Please allow 6-8 weeks for processing. If you do not receive
your rebate after 8 weeks visit Lowes.com/Rebates, or you may call 1-877-204-1223.
4. Please keep a copy of all materials submitted for your records.5. Mail this completed form along with a photocopy of your cash
register receipt showing purchase of qualifying product(s).
10% Rebatevia Samsung Visa® Prepaid Card by mail
*Purchase price is calculated before taxes and after discounts, if any. Products purchased must be from three different product categories. Eligible categories are laundry, refrigerators, ranges, dishwashers, wall ovens, cooktops, OTR or range hoods. Offer excludes Samsung Chef Collection, countertop microwaves, vacuums and all accessories in addition to clearance or previous sales. Offer cannot be combined with any other Samsung authorized rebate program or with any other coupon or discount.
Purchase three (3) or more qualifying Samsung appliances to be eligible to receive a rebate in the amount of 10% of the pre-tax purchase price on a Samsung Visa Prepaid Card when you submit via mail or online.
To receive your rebate: MAIL TO:Lowe's Samsung Appliance Suite RebateOffer # 268177PO Box 750616El Paso, TX 88575-0616
Sales DateStore #Invoice #Offer # 268177*If purchased online, please wait until order is received.
*SUBMIT ONLINE:
See reverse side for list of qualifying appliance models.
Page 1 of 4
QUALIFYING SAMSUNG APPLIANCES
RF22N9781SGRF22N9781SRRF28N9780SGRF28N9780SRRF23M8590SGRF23M8590SRRF23M8570SGRF23M8570SRRF22R7551DTRF22R7551SGRF22R7551SRRF28R7551DTRF28R7551SGRF28R7551SRRF265BEAESGRF265BEAESRRF22K9381SGRF22K9381SRRF28K9380SGRF28K9380SRRF23J9011SGRF23J9011SRRF28K9070SGRF28K9070SRRF23M8090SGRF23M8090SRRF22R7351DTRF22R7351SGRF22R7351SRRF28R7351DTRF28R7351SGRF28R7351SRRF23M8070DTRF23M8070SGRF23M8070SRRF24R7201DTRF24R7201SGRF24R7201SRRF28R7201DTRF28R7201SGRF28R7201SR
RF25HMEDBSGRF25HMEDBSRRF25HMEDBWW
RF28R6301DTRF28R6301SGRF28R6301SRRF23R6301SRRF23R6201DTRF23R6201SGRF23R6201SR
Model # Stock Item #
103090610389701038971103897275177685527384549484549513923761392377139237313923751392374
845502845503780370780371780368780369691972632833780372780373855274855275129570912957081295707875932
143834284549684549712957061295705
780377726801580486135733313573341357335135733913573361357337888362
SOS Item #
Refrigerator
1030905
1392372
689595712503746656
751817488377
689594
876275
129570412957031295702
876372
1295701129570012956991295698714680511090
887926
1350876
RF23R6201WWRF28R6241SRRF28R6201DTRF28R6201SGRF28R6201SRRF28R6202WWRF26J7500SRRF263TEAESGRF263TEAESRRF263BEAESGRF263BEAESRRF263BEAEWWRF261BEAESGRF261BEAESRRF261BEAEWWRF260BEAESGRF260BEAESRRF260BEAEWWRF220NCTASGRF220NCTASRRF220NCTAWWRF20HFENBSGRF20HFENBSRRF20HFENBWWRF18HFENBSGRF18HFENBSRRF18HFENBWWRH25H5611SGRH25H5611SRRH25H5611WWRS22HDHPNSRRS22HDHPNWWRS25H5111SGRS25H5111SRRS25H5111WWRS22T5561SGRS22T5561SRRS27T5561SGRS27T5561SRRS22T5201SGRS22T5201SRRS27T5200SGRS27T5200SRRS27T5200WWRT21M6215SGRT21M6215SRRT21M6215WWRT21M6213SGRT21M6213SRRT21M6213WWRT18M6215SG
Model # Stock Item #
1357338
13573301357331
1357332632834
697438693237580483580482805355121872124039805356121887883880273196947118272538195886365226965227295886265227365227078037812188796328506067466120256884247239518381841654832165483316548371654838165482916548311654834
16548361484995148499614849936907096912366907101484998
SOS Item #
Refrigerator
1341474
668701751820185563751819
730693186006186010772684434627
719466
648958
568253
723983568255568256
1654839
1654830
1654835
490498847229
RT18M6215SRRT18M6215WWRT18M6213SGRT18M6213SRRT18M6213WW
Model # Stock Item #
14849971484994690711690706691237
SOS Item #
Refrigerator
490586
847230
Page 2 of 4
DV42H5000EWDV42H5000GWWV60M9900AWDVE60M9900WDVG60M9900WWV60M9900AVDVE60M9900VDVG60M9900VWV55M9600AWDVE55M9600WDVG55M9600WWV55M9600AVDVE55M9600VDVG55M9600VWA52M8650AWDVE52M8650WDVG52M8650WWA52M8650AVDVE52M8650VDVG52M8650VWA52M7750AWDVE52M7750WDVG52M7750WWA52M7750AVDVE52M7750VDVG52M7750VWA50R5400AVDVE50R5400VDVG50R5400VWA50R5400AWDVE50R5400WDVG50R5400WWA50R5200AWDVE50R5200WDVG50R5200WWA45N3050AWDV40J3000EWDV40J3000GWWA54R7600AVDVE54R7600VDVG54R7600VWA54R7600ACDVE54R7600CDVG54R7600CWA54R7600AWDVE54R7600WDVG54R7600WWA54R7200AWDVE54R7200WDVG54R7200WWA54R7200AVDVE54R7200VDVG54R7200V
835625835626835627835628835629835630835631835632835633835634835635835636835650835651835652835653835654835655835641835642835643844407844408844409
593661632882156958215695831569584
141486614148671414868141486914148701414871141487214148731414874
566002566003835579835580835581740399835583835584835585835586835587835588835589835590835604835605835606835607835608835609
8444048444058444061258845125884612588471258848125884912588501258851125885212588531100392669553669554141487814148791414880143843014384311438432
WF50K7500AVDV50K7500EVDV50K7500GVWF50K7500AWDV50K7500EWDV50K7500GWWW22N6850QXDVE22N6850XDV22N6850HX
WW22K6800AWDV22K6800EWDV22N6800HWWF45K6500AVDV45K6500EVDV45K6500GVWF45K6500AWDV45K6500EWDV45K6500GWWF45R6300ACDVE45R6300CDVG45R6300CWF45R6300AVDVE45R6300VDVG45R6300VWF45R6300AWDVE45R6300WDVG45R6300WWF50R8500AWDVE50R8500WDVG50R8500WWF50R8500AVDVE50R8500VDVG50R8500VWF45R6100ACDVE45R6100CDVG45R6100CWF45R6100APDVE45R6100PDVG45R6100PWF45R6100AWDVE45R6100WDVG45R6100WWF42H5000AW
Model # Stock Item #
7123677123687123757147697147707147711157136115713711571387831877831881157139712393712395717633714772714773714774134568513456861345687
141486314148641414865
SOS Item #
Laundry
780047780048780049780050780051780052
780053780054780055780056780057780058
126006212600631260064126006512600661260067
141487514148761414877125883912588401258841150152415015251501526125884212588431258844566001
Page 3 of 4
DV42H5000EWDV42H5000GWWV60M9900AWDVE60M9900WDVG60M9900WWV60M9900AVDVE60M9900VDVG60M9900VWV55M9600AWDVE55M9600WDVG55M9600WWV55M9600AVDVE55M9600VDVG55M9600VWA52M8650AWDVE52M8650WDVG52M8650WWA52M8650AVDVE52M8650VDVG52M8650VWA52M7750AWDVE52M7750WDVG52M7750WWA52M7750AVDVE52M7750VDVG52M7750VWA50R5400AVDVE50R5400VDVG50R5400VWA50R5400AWDVE50R5400WDVG50R5400WWA50R5200AWDVE50R5200WDVG50R5200WWA45N3050AWDV40J3000EWDV40J3000GWWA54R7600AVDVE54R7600VDVG54R7600VWA54R7600ACDVE54R7600CDVG54R7600CWA54R7600AWDVE54R7600WDVG54R7600WWA54R7200AWDVE54R7200WDVG54R7200WWA54R7200AVDVE54R7200VDVG54R7200V
835625835626835627835628835629835630835631835632835633835634835635835636835650835651835652835653835654835655835641835642835643844407844408844409
593661632882156958215695831569584
141486614148671414868141486914148701414871141487214148731414874
566002566003835579835580835581740399835583835584835585835586835587835588835589835590835604835605835606835607835608835609
8444048444058444061258845125884612588471258848125884912588501258851125885212588531100392669553669554141487814148791414880143843014384311438432
WF50K7500AVDV50K7500EVDV50K7500GVWF50K7500AWDV50K7500EWDV50K7500GWWW22N6850QXDVE22N6850XDV22N6850HX
WW22K6800AWDV22K6800EWDV22N6800HWWF45K6500AVDV45K6500EVDV45K6500GVWF45K6500AWDV45K6500EWDV45K6500GWWF45R6300ACDVE45R6300CDVG45R6300CWF45R6300AVDVE45R6300VDVG45R6300VWF45R6300AWDVE45R6300WDVG45R6300WWF50R8500AWDVE50R8500WDVG50R8500WWF50R8500AVDVE50R8500VDVG50R8500VWF45R6100ACDVE45R6100CDVG45R6100CWF45R6100APDVE45R6100PDVG45R6100PWF45R6100AWDVE45R6100WDVG45R6100WWF42H5000AW
7123677123687123757147697147707147711157136115713711571387831877831881157139712393712395717633714772714773714774134568513456861345687
141486314148641414865
780047780048780049780050780051780052
780053780054780055780056780057780058
126006212600631260064126006512600661260067
141487514148761414877125883912588401258841150152415015251501526125884212588431258844566001
Model # Stock Item # SOS Item #
Laundry
MC17J8000CGMC17J8000CSME21K7010DGME21K7010DSME21R706BATME21M706BAGME21M706BASME21R7051SGME21R7051SSME20H705MSSME19R7041FTME19R7041FGME19R7041FSME19R7041FBME19R7041FWME18H704SFGME18H704SFSME16H702SESME16H702SEBME16H702SEWME16K3000AS
Model # Stock Item #
821969694339712356 719737 13136098947008947021365009136500866866214399241521815
14399211439922693234
663233663234719739
SOS Item #
Microwave
7532137804367804371313610884089
631209
1499909
753250589359589363589362589361780438
NE58K9850WGNE58K9850WSNE58R9560WGNE58K9560WSNE58F9710WSNE58K9500SGNE58F9500SSNE58R9431STNE58R9431SGNE58R9431SSNE58N9430SGNE58K9430SSNE58R9311SSNE59J7850WGNE59J7850WSNE59M6850SGNE59M6850SSNE59N6650SGNE59N6650SSNE59R6631STNE59R6631SGNE59R6631SSNE59N6630SGNE59N6630SSNE59R4321SGNE59R4321SSNE59M4320SGNE59M4320SSNE59M4320SBNE59M4320SWNE59T4311SSNE59M4310SSNY58J9850WSNX58K9850SGNX58K9850SSNX58K9500WGNX58H9500WSNX58R9421STNX58R9421SGNX58R9421SSNX58N9420SGNX58M9420SSNX58R9311SSNX58K7850SGNX58K7850SSNX58M6850SGNX58M6850SSNX58M6650WGNX58M6650WSNX58R6631STNX58R6631SG
Model # Stock Item #
710824 712345 1313611719731 657133712346
1296034136501313650121175595719736 143992075474166642669010069009798619898619912960321339552133955198619698619713395501339549690098690099783288783284
840665702723719733 719734719735 6125661296035136501113650101175596
1439923719747 719748 69009569009491154289470312960331339548
SOS Item #
Range
780425780426
5024117804275024091296028
780428888137694051670654845532 845533
1296026
986194986195
845534 845535
8387707466607804307804317804326318691296029
845536888138780433780434 845537 845538884090
1296027
NX58R6631SSNX58M6630SGNX58M6630SSNX58T5601SGNX58T5601SSNX58T5601SBNX58T5601SWNX58J5600SGNX58H5600SSNX58M5600SBNX58M5600SWNX58R4311SGNX58R4311SS
Model # Stock Item #
1339547894704894701
69399312734692303592303612960311296030
SOS Item #
Range
884091
751811617237
1261928
NV51R5511SSNV51R5511SGNV51R5511DSNV51R5511DGNV51K6650SSNV51K6650SGNV51K6650DSNV51K6650DGNV51K7770SSNV51K7770SGNV51K7770DSNV51K7770DG
Model # Stock Item #
1601245160124016012481601239732189732181732213732204732191732190732215732194
SOS Item #
Wall Oven
817849771504785076785074
741206
738230
Page 4 of 4
NQ70R5511DSNQ70R5511DGNQ70M6650DSNQ70M6650DGNQ70M7770DSNQ70M7770DG
Model # Stock Item #
16012541601241783286783285783287783289
SOS Item #
Microwave/Wall Oven Combo
741207
NZ30R5330RKNZ36R5330RKNZ30K6330RSNZ30K6330RGNZ36K6430RSNZ36K6430RGNZ30K7570RSNZ30K7570RGNZ36K7570RSNZ36K7570RGNZ30K7880USNZ30K7880UGNZ36K7880USNZ36K7880UGNA30R5310FSNA30R5310FGNA36R5310FSNA36R5310FGNA30N6555TSNA30N6555TGNA36N6555TSNA36N6555TGNA30N7755TSNA30N7755TGNA36N7755TSNA36N7755TG
Model # Stock Item #
16012441601252732195732196732197732198732200732199732201732206732208732210732211732203160124916012431601251160125311446521144653114465411446551144656114465711446581144659
SOS Item #
Cooktop
823562741205
773992
785077
819738
819740
819739
819741
NK30R5000WSNK30R5000WGNK36R5000WSNK36R5000WGNK30K7000WSNK30K7000WGNK36K7000WSNK36K7000WGNK30N7000UGNK30N7000USNK36N7000UGNK36N7000US
Model # Stock Item #
16012501601246160124216012477335437335457335447335421083052108305310830501083051
SOS Item #
Range Hood
744110
773985
DW80R9950UTDW80R9950UGDW80R9950USDW80R7060UGDW80R7060USDW80R7061UGDW80R7061USDW80R5060UGDW80R5060USDW80R5061UTDW80R5061UGDW80R5061USDW80N3030USDW80N3030UBDW80N3030UWDW80R2031USDW60R2014US
Model # Stock Item #
13035501303548130354914105541410555
14105531410552
141055814105561410557
1147764114776513367761452299
SOS Item #
Dishwasher
130354713035451303546
1354367
1354366
1147763
1336775