Follow these simple instructions to receive your manufacturers rebate. Buy, Share, Redeem, and Rebate Responsibly Step One: Please add a payment method to your Shared Spirits account for receipt of your rebate. All rebates are distributed digitally. Step Two: Please complete the form below in its entirety. Name * First Name Last Name Address * Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Curacao Cyprus Czech Republic Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Nagorno-Karabakh Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Turkish Republic of Northern Cyprus Northern Mariana Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Republic of the Congo Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia South Sudan Spain Sri Lanka Sudan Suriname Svalbard eSwatini Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Transnistria Pridnestrovie Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands Isle of Man US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Email * example@example.com Cell Number Associated with the Download of the Shared Spirits App * – Area Code Phone Number First Preference * Beer – Craft Beer – Domestic Beer – Imported Bourbon Cordial – After Dinner Cordial – Amaro Gin Irish Whiskey Rum Scotch Spirit – Other Tequila Vodka Whiskey Wine – Cabernet Sauvignon Wine – Champagne Wine – Chardonnay Wine – French Wine – Italian Wine – Malbec Wine – Merlot Wine – Other Red Wine – Other White Wine – Pinot Grigio/Gris Wine – Pinot Noir Wine – Reisling Wine – Rose Wine – Sauvignon Blanc Wine – Sparkling Wine – Syrah/Shiraz What Drink do You Enjoy Most? Second Preference * Beer – Craft Beer – Domestic Beer – Imported Bourbon Cordial – After Dinner Cordial – Amaro Gin Irish Whiskey Rum Scotch Spirit – Other Tequila Vodka Whiskey Wine – Cabernet Sauvignon Wine – Champagne Wine – Chardonnay Wine – French Wine – Italian Wine – Malbec Wine – Merlot Wine – Other Red Wine – Other White Wine – Pinot Grigio/Gris Wine – Pinot Noir Wine – Reisling Wine – Rose Wine – Sauvignon Blanc Wine – Sparkling Wine – Syrah/Shiraz What Drink do You Most When You’re Not Ordering Your First Choice? Third Preference * Beer – Craft Beer – Domestic Beer – Imported Bourbon Cordial – After Dinner Cordial – Amaro Gin Irish Whiskey Rum Scotch Spirit – Other Tequila Vodka Whiskey Wine – Cabernet Sauvignon Wine – Champagne Wine – Chardonnay Wine – French Wine – Italian Wine – Malbec Wine – Merlot Wine – Other Red Wine – Other White Wine – Pinot Grigio/Gris Wine – Pinot Noir Wine – Reisling Wine – Rose Wine – Sauvignon Blanc Wine – Sparkling Wine – Syrah/Shiraz What Drink do You Enjoy Most When You’re Not Ordering Your First or Second Choice? Take a photo of your UPC Code on the Bottle Label and Upload it Here Take a Photo of Your Retailer Receipt and Upload it Here Take a Photo of the Receipt Verifying the Purchase the Product. Note, it must be clear. Take a Photo of the UPC Code on the Bottle Qualified for the Rebate. Note, it must be clear. Do You Consider Yourself an Expert in Any of the Drink Categories? * Yes I’m in the Industry No Please Sign Attesting to Your Age and Verifying Your Purchase. Important note! No Rebates will be Made to Those Who Have Not Upload the Receipt and UPC Code Applicable to Their Qualifying Purchase * I Understand Submission of Rebate Form Denotes Acceptance of Shared Spirits, Inc. Privacy Policies and Terms and Conditions. Submit my Rebate Request! Should be Empty:
