Program Dates: 04/01/2013 - 05/31/2013 $50/$100 Certified Service Visa® Prepaid Card Rebate Offer To receive your $50/$100 Certified Service Visa Prepaid Card by mail follow these conditions of acceptance: 1) Purchase and have installed, a set of four (4) Qualifying (listed below) at a participating , , GMC or dealer between April 1, 2013 and May 31, 2013. 2) Complete all information requested on this form accurately and legibly. Or you can pre-qualify online for faster processing by visiting www.mycertifiedservicerebates.com and follow the online instructions to submit your rebate. 3) Make a clean, legible copy of your Invoice/Repair Order including the dealer identification and circle the purchase(s) and installation of the qualifying service. 4) Mail a copy of your Invoice/Repair Order and this completed rebate form to the address below. Submission must be postmarked by June 30, 2013. 5) To check the status of your submission, visit the “My Rebate Status” section at www.mycertifiedservicerebates.com. (If manually submitting, rebate status may not be available for up to 2 weeks after mailing.) Mail to: Certified Service Tire Rebate Offer # H944171 PO Box 101206 White Bear Lake, MN 55110-1201

(!) IMPORTANT: Photocopy your entire submission for your records. You may be required to mail or fax these photocopies. Customer Information Section *Denotes Required Fields. *First Name *Last Name

*Address

*City *State *Zip Code

Email Phone

Please check here if you would like to receive email or mail communications for service offers. To read the GM Privacy Statement, go to www.gm.com/privacy. Qualifying Tire Brands $100 Rebate: Bridgestone Continental Goodyear Hankook Pirelli Please check which brand you purchased: $50 Rebate: BFGoodrich Dunlop Firestone General *Dealership Name *Dealer Zip Code *Date of Service (MM/DD/YY)

*Invoice/Repair Order Number Vehicle VIN Number

*GM Part Number of FRONT Tires Purchased and Installed Write both FRONT and REAR *GM Part Number of REAR Tires Purchased and Installed Tire Part Numbers, even if the ______Numbers are the same. ______This offer requires the purchase and installation of four (4) Tires in order to be eligible for a rebate. The 7 or 8 digit GM Part Number(s) from your Invoice/Repair Order must be included in the space provided above. Please fill in both Front and Rear, even if they are the same. If the Part Number(s) is not included on your Invoice/Repair Order, contact your dealer to obtain the required information.

Online Mailer Radio Dealership Employee Signs Outside the Dealership *How did you first hear about this offer? Signs Inside the Dealership Television Other Dealership Home Local Independent Service Chain Firestone NTB Where do you normally have your tires serviced? Pep Boys Sears Valvoline Wal-Mart Midas Other To check the status of your submission, visit the “My Rebate Status” section at www.mycertifiedservicerebates.com. (If manually submitting, rebate status may not be available for up to 2 weeks after mailing.) Rebates are available to customers who have the service performed at a participating Chevrolet, Buick, GMC or Cadillac dealer located in the United States and U.S. territories. Approved rebate submissions will receive a Visa® prepaid card. Your right to receive this rebate will not be earned unless you satisfy the rebate requirements as outlined on this rebate application. Failure to comply with the rebate requirements will disqualify your rebate. This offer is available to all customers with mailing addresses in the United States and U.S. territories. This offer is not valid on products being replaced under warranty. This offer is for retail customers only. Fleet and Commercial customers and GM Company Vehicles are not eligible for this offer. Internal dealership sales are not eligible for this offer. This offer cannot be combined with any other offers, or tire manufacturer rebates and/or specials, unless specified in writing by General Motors. Limit one (1) rebate per service performed per service date and vehicle. Maximum of two (2) rebates per address for this promotion.Your rights to this offer cannot be assigned or transferred. This offer is void where taxed, restricted or prohibited by law. General Motors and their partners are not responsible for lost, late, damaged, illegible, misdirected or postage-due submissions. Excessive submissions constitute fraud and may result in federal prosecution under the U.S. mail fraud statutes (Title 18, USC 1341 and 1342). Any misrepresentation or fraudulent information disqualifies the rebate and may give rise to criminal or civil prosecution. All rebates shall be governed by applicable state and federal laws. All terms, conditions and rules of this program are subject to change. All submitted materials become property of General Motors and will not be returned. GM Certified Service Visa Prepaid Cards are issued by Citibank, N.A. pursuant to a license from Visa U.S.A. Inc. and managed by Citi Prepaid Services. Cards require activation prior to use, and are paid in U.S. dollars. Cards can be used everywhere Visa debit cards are accepted. Cards do not have cash access and cannot be used at ATMs. Cards expire 6 months from the issuance date. Please allow up to 8 weeks for delivery of the rebate. You should retain copies of your rebate submission for your records. For additional questions, you may visit www.mycertifiedservicerebates.com or call 1-877-476-8419 weekdays, 8am to 7pm CT. (GHH) GM-FM-0062-13E