To quality for your rebate, fill out this form in its entirety and mail it in an addressed and stamped
envelope, along with copies of your Sam’s Club receipts (dated 7/1/11 – 12/15/11) and the UPC
codes from the qualifying purchased boxes of Barber Foods Premium Entrées, to the address
below. Allow 6-8 weeks for your rebate. Maximum rebate of $10.00
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