$10 CASH BACK CLAIM FORM

"Yes I have responded to the Ready Steady Cook BRITA advertisement and I am now the proud owner of a BRITA Filter System." To claim your $10 cash back on a Brita Water Filter Jug or On Tap system purchased before 30th October 2008, please complete this form and send it together with the barcode and store receipt to the following address:

Brita Cash Back PO Box 6066, Frenchs Forest, NSW 2086

Name:
Address:
Suburb:
State:
Postcode:
System Purchased:
Date of Purchase:
Receipt enclosed:
 yes
Barcode Enclosed:
 yes
Store Name:
Store Branch/Suburb:

Claims must be received by 30th November 2008. Only one application per household will be accepted. Not to be used with any other concurrent offer. Please allow 28 days for your application to be fulfilled. Refund will take the form of a $10 cheque (in local currency) made payable to the name provided above. No responsibility accepted for late, lost or misdirected claims.

Cash Back
Upon filling this form in and submitting it a cash back voucher will display in place of this text.

Print and post the voucher with your store receipt and product barcode.