Individual Rebate Sheet

	My Tracking Code (unique)
Purchase Info	Item
	Store
	Date purchased/received
	$ Paid (before rebate)
Rebate Info	Rebate Amount
	Valid purchase dates
	Last date to mail in
	Expected return (E.g. 6-8 weeks, or 30 days)
	Mailing to
	Contact	Phone
		Email
		Web

Item	Mail In	My Copy ¹
Completed Form
UPC (copy ok?)
Receipt (copy ok?)
Packing Slip
Addressed Envelope
Stamp
Other
Copy of Ad	n/a
Name used on form ²
Date mailed in
Mailed before "Last date to mail in"?
Due (Latest date expected)

Notes:

¹ Hardcopy or online image. It might be helpful to keep all the paperwork for each rebate in a separate manilla folder.
² May need exact form of name to check some rebate web sites (e.g. Tom vs. Thomas).
Copy grey items to Summary/Status Sheet