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Rebate Claim
Customer Information
Business Name
*
Distributor Information
Distributor Name
*
Select
Colour Connection Dunedin
Complete Paints Napier
Complete Paints Palmerston North
Guthrie Bowron Greymouth
Guthrie Bowron Motueka
Guthrie Bowron Nelson
Hardy Packaging New Plymouth
Linkup Paints Gisborne
Linkup Paints Hamilton
Linkup Paints Tauranga
Linkup Performance Coatings Auckland
Linkup Performance Coatings Wellington
Paint Centre Wairau
Paint Centre Whangarei
Distributor representative
Name of Distributor representative filling out the rebate form
Distributor Email Address
*
Date
*
Rebate Information
Invoice or Product
Invoice
Product
Please specify if you are claiming via "Invoice" or "Product/s"
Invoice information
Invoice Number
Total Amount
NZD
Rebate %
Auto-Calculated Rebate Amount
$
Product(s) information
Product Code
Packaging Size
Quantity
Unit Value
NZD
Rebate %
Auto-Calculated Rebate Amount
$
Add another product?
Yes
No
Product #2
Product Code
Packaging Size
Quantity
Unit Value
NZD
Rebate %
Auto-Calculated Rebate Amount
$
Add another product?
Yes
No
Product #3
Product Code
Packaging Size
Quantity
Unit Value
NZD
Rebate %
Auto-Calculated Rebate Amount
$
Add another product?
Yes
No
Product #4
Product Code
Packaging Size
Quantity
Unit Value
NZD
Rebate %
Auto-Calculated Rebate Amount
$
Add another product?
Yes
No
Product #5
Product Code
Packaging Size
Quantity
Unit Value
NZD
Rebate %
Auto-Calculated Rebate Amount
$
Total Rebate
Claim description
Mandatory field
Customer Invoice
Upload Invoice (PDF, JPG, PNG)
*
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No file chosen
Delete uploaded file
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