**Please use your own discression with utilizing this form**
To receive your mail-in-rebate: Purchase Fresh Sacks (25's) and send in this completed form, along with a
copy of your original cash register receipt and the original UPC code from the product package. Amount
of the rebate is equal to the purchase price, excluding any tax, not to exceed $5.97 US dollars. You pay tax.
*Fresh Sacks MIR
*Walgreens $5.00 rebate for fresh sacks