$500/$750 GM Visa Prepaid Card Connect & Cruise Rebate Offer

$500/$750 GM Visa? Prepaid Card Connect & Cruise Rebate Offer

Automatic Carbureted Crate Powertrain System Offer Valid: 01/01/2018 - 12/31/2018

To receive your Visa prepaid card by mail follow these conditions of acceptance:

1) Purchase a Chevrolet Performance Crate Powertrain system between January 1, 2018 and December 31, 2018.

2) Complete all information requested on this form accurately and legibly. Make a clean, legible copy of the GM Dealer Invoice/Repair Order. The invoice must have the Dealer and eligible part purchases circled.

3) Submit your rebate on-line for faster processing or via mail. To submit on-line: Use a computer, tablet or mobile phone, go to and follow the instructions. You will be required to upload a copy of your Invoice/Repair Order. To submit via mail: Mail this form, along with a copy of your GM Dealer Invoice, to the address below. Submission must be postmarked by January 31, 2019.

4) By providing your contact information below, you consent that GM and/or a GM dealer can contact me with any GM offers and GM product information. For more information on the GM Privacy Statement please visit our website or call 1-866-MYPRIVACY (1-866-697-7482).

Mail to:

Connect & Cruise Powertrain Rebate Offer Number 66040 PO Box 6970 Mesa, AZ 85216

Customer Information Section

*Denotes Required Field

*First Name

*Last Name

*Address *City Email

*State Phone

*Zip Code

(!) IMPORTANT: Photocopy your entire submission for your records. You may be required to mail or fax these photocopies.

*Dealer/Authorized Reseller Location

*Dealer/Authorized Reseller Zip Code

*Date of Purchase (MM/DD/YY)

*Invoice/Repair Order Number

Check the box next to the Model and corresponding 8 digit GM Part Numbers for the system purchased on your Invoice/Repair Order.

Small Block

LS

Big Block

350/290 Deluxe w/ 4L65E Transmission

$500 Rebate 19355659 19332781 19368611 19299800 19332775

SP350/357 Turn-Key w/ 4L65E Transmission LS 376/515 w/ 4L70E ZZ427/480 w/ 4L70E Transmission 502 HO w/ 4L85E Transmission

$500 Rebate

Transmission

$500 Rebate

$500 Rebate

19367084 19332781

$500 Rebate

19331572 19332781

12568778 19332784

19368611 19299801

19301359

19368613 19299801

19300175 19299804

19332775

19259117

19332775

19332780

19368613 350 HO Turn-Key w/ 4L65E Transmission SP350/385 Turn-Key w/ 4L65E Transmission 19299803

$500 Rebate 19355662 19332781

$500 Rebate 19333158 19332781

19332775

19368611 19299800

19368611 19299801

19332775

19332775

454 HO w/ 4L85E Transmission

$500 Rebate 12568774 19332784 19300175 19299804 19332780

ZZ502/502 Deluxe w/ 4L85E Transmission

$500 Rebate 19331579 19332784 19300175 19299805 19332780

Ram Jet 350 w/ 4L65E Transmission

$500 Rebate 19355815 19332781 19368611 19299800 19332775

SP383 Deluxe w/ 4L70E

Transmission$500 Rebate 19355722 19332781 19368613 19299801 19332775

ZZ454/440 w/ 4L85E Transmission ZZ572/620 Deluxe w/ 4L85E Transmission

$500 Rebate

$750 Rebate

19331574 19332784

19331583 19332784

19300175 19299804

19300175 19299805

19332780

HT 383 w/ 4L70E Transmission

$500 Rebate 19355720 19332781 19368613 19299800 19332775

ZZ6 Base w/ 4L65E Transmission $500 Rebate 19351532 19332781 19368611 19299801 19332775

HT502 w/ 4L85E Transmission

$500 Rebate 88890534 19332784 19300175 19299804 19332780

ZZ572/720R Deluxe w/ 4L85E Transmission

$750 Rebate 19331585 19332784 19300175 19299805 19332780

SP350/385 Base w/ 4L65E Transmission ZZ6 Turn-Key w/ 4L65E Transmission

$500 Rebate

$500 Rebate

19333157 19332781

19351533 19332781

19368611 19299801

19368611 19299801

19332775

19332775

Ram Jet 502 w/ 4L85E Transmission

$500 Rebate 12499121 19332784 19300175 19299804 19332780

All of the applicable 8 digit GM Part Numbers must be purchased on the same Invoice/Repair Order and must match what is checked on this form.

To check the status of your rebate visit "Status Lookup" at or call 844.656.5369 weekdays, 7 am to 11 pm Eastern Time. Please allow up to 8 weeks for rebate processing.

Offer valid for customers who make the purchase at a participating Chevrolet, Buick, GMC or Cadillac Dealer or Authorized Reseller located in the United States and U.S. territories. In order to receive the mail-in rebate debit card, qualifying purchases must satisfy the rebate requirements as outlined on this rebate application. Failure to meet the mail-in rebate requirements will disqualify your rebate. This offer is available to retail customers with mailing addresses in the United States and U.S. territories. This offer is not valid on products being replaced under warranty. Fleet and commercial customers and GM Company Vehicles are not eligible for this offer. Internal dealership sales are not eligible for this offer. This offer cannot be combined with other General Motors offers. Limit one (1) rebate per service performed per service date and vehicle and cannot be assigned or transferred. This offer is void where taxed, restricted or prohibited by law. General Motors and their partners are not responsible for lost, late, damaged, illegible, misdirected or postage-due submissions. Any excessive submissions, misrepresentation or fraudulent information disqualifies the rebate and may give rise to criminal or civil prosecution. All rebates shall be governed by applicable state and federal laws. All terms, conditions and rules of this program are subject to change. All submitted materials become property of General Motors and will not be returned. Rebate paid in the form of a Visa prepaid card. General Motors reserves the right to substitute a check of equal value in lieu of a Visa prepaid card at its discretion. Card is issued by MetaBank?, Member FDIC, pursuant to a license from Visa U.S.A. Inc. No cash access or recurring payments. Can be used everywhere Visa debit cards are accepted. Card valid for up to 12 months; unused funds will be forfeited at midnight EST the last day of the month of the valid thru date. Card terms and conditions apply; see site/visa-promo. Please allow up to 8 weeks for delivery of the rebate.

Revision #2

$500/$750 GM Visa? Prepaid Card Connect & Cruise Rebate Offer

Automatic Fuel-Injected Crate Powertrain System Offer Valid: 01/01/2018 - 12/31/2018

To receive your Visa prepaid card by mail follow these conditions of acceptance:

1) Purchase a Chevrolet Performance Crate Powertrain system between January 1, 2018 and December 31, 2018.

2) Complete all information requested on this form accurately and legibly. Make a clean, legible copy of the GM Dealer Invoice/Repair Order. The invoice must have the Dealer and eligible part purchases circled.

3) Submit your rebate on-line for faster processing or via mail. To submit on-line: Use a computer, tablet or mobile phone, go to and follow the instructions. You will be required to upload a copy of your Invoice/Repair Order. To submit via mail: Mail this form, along with a copy of your GM Dealer Invoice, to the address below. Submission must be postmarked by January 31, 2019.

4) By providing your contact information below, you consent that GM and/or a GM dealer can contact me with any GM offers and GM product information. For more information on the GM Privacy Statement please visit our website or call 1-866-MYPRIVACY (1-866-697-7482).

Mail to:

Connect & Cruise Powertrain Rebate Offer Number 66040 PO Box 6970 Mesa, AZ 85216

*First Name

Customer Information Section

*Last Name

*Denotes Required Field

*Address

*City

*State

*Zip Code

Email

Phone

(!) IMPORTANT: Photocopy your entire submission for your records. You may be required to mail or fax these photocopies.

*Dealer/Authorized Reseller Location

*Dealer/Authorized Reseller Zip Code

*Date of Purchase (MM/DD/YY)

*Invoice/Repair Order Number

Check the box next to the Model and corresponding 8 digit GM Part Numbers for the system purchased on your Invoice/Repair Order.

LS/LT

L96 (6.0L) 2WD w/ 4L65E Transmission $500 Rebate 12677741 19368611 19356410 19299802 19259117 19302405

L96 (6.0L) 4WD w/ 4L65E Transmission $500 Rebate 12677741 19368612 19356410 19299802 19259117 19302405

LS7 (7.0L) w/ 4L70E Transmission $750 Rebate 19299802 or 19299803 19329246 19354334 19259117 19368613 19302405

LS7 (7.0L) w/ 4L75E Transmission $750 Rebate 19299802 or 19299803 19329246 19354334 19259117 19368615 19302405

LS376/480 w/ 4L70E Transmission $500 Rebate 19301358 19299803 19354330 19302405 19259117 19368613

LS3 (6.2L) 2WD w/ 4L65E Transmission $500 Rebate 19301326 19299802 19354328 19302405 19259117 19368611

LS3 (6.2L) 4WD w/ 4L70E 4WD Transmission $500 Rebate 19301326 19299802 19354328 19302405 19259117 19368612

LS3 (6.2L) E-ROD w/ 4L65E Transmission $500 Rebate 19257230 19299802 19259117 19302405 19368611

LS376/525 w/ 4L70E Transmission $500 Rebate 19301360 19299803 19354332 19302405 19259117 19368613

LS376/525 w/ 4L75E Transmission $750 Rebate 19301360 19354332 19259117 19368615 19299803 19302405

LT1 (6.2L) Dry Sump w/ 4L70E Transmission $500 Rebate 19329997 19299802 19368831 19302405 19329416 19368614

LT1 (6.2L) Wet Sump w/ 4L70E Transmission $500 Rebate 19355405 19299802 19368833 19302405 19368614 19329416

LT1 (6.2L) E-ROD Wet Sump w/ 4L70E Transmission $500 Rebate 12682080 19302405 19368614 19329416 19299802

LT1 (6.2L) w/ 8L90E Transmission $500 Rebate 19355405 19367134 19368835 24283284

LT376/535 w/ 4L75E Transmission $500 Rebate 19355378 19299803 19368837 19302405 19329416 19368615

LSA (6.2L) E-ROD w/ 4L75E Transmission $750 Rebate 19257456 19368615 19299802 19302405 19259117

LSA (6.2L) NON E-ROD w/ 4L85E Transmission $750 Rebate 19331507 19299806 19300175 19259119 19302410

LT4 (6.2L) Dry Sump w/ 4L75E Transmission $500 Rebate 19332702 19368615 19368843 19299802 19329416 19302405

LT4 (6.2L) Wet Sump w/ 4L75E Transmission $500 Rebate 19368622 19368615 19368843 19299802 19329416 19302405

LT4 (6.2L) Wet Sump w/ 8L90E Transmission $500 Rebate 19368622 19367135 19368845 24284144

LSA (6.2L) E-ROD w/ 4L85E Transmission $750 Rebate 19257456 19300175 19259119 19299806 19302410

LSA (6.2L) NON E-ROD w/ 4L75E Transmission $750 Rebate 19331507 19354336 19368615 19299802 19302405 19259117

All of the applicable 8 digit GM Part Numbers must be purchased on the same Invoice/Repair Order and must match what is checked on this form.

To check the status of your rebate visit "Status Lookup" at or call 844.656.5369 weekdays, 7 am to 11 pm Eastern Time. Please allow up to 8 weeks for rebate processing.

Offer valid for customers who make the purchase at a participating Chevrolet, Buick, GMC or Cadillac Dealer or Authorized Reseller located in the United States and U.S. territories. In order to receive the mail-in rebate debit card, qualifying purchases must satisfy the rebate requirements as outlined on this rebate application. Failure to meet the mail-in rebate requirements will disqualify your rebate. This offer is available to retail customers with mailing addresses in the United States and U.S. territories. This offer is not valid on products being replaced under warranty. Fleet and commercial customers and GM Company Vehicles are not eligible for this offer. Internal dealership sales are not eligible for this offer. This offer cannot be combined with other General Motors offers. Limit one (1) rebate per service performed per service date and vehicle and cannot be assigned or transferred. This offer is void where taxed, restricted or prohibited by law. General Motors and their partners are not responsible for lost, late, damaged, illegible, misdirected or postage-due submissions. Any excessive submissions, misrepresentation or fraudulent information disqualifies the rebate and may give rise to criminal or civil prosecution. All rebates shall be governed by applicable state and federal laws. All terms, conditions and rules of this program are subject to change. All submitted materials become property of General Motors and will not be returned. Rebate paid in the form of a Visa prepaid card. General Motors reserves the right to substitute a check of equal value in lieu of a Visa prepaid card at its discretion. Card is issued by MetaBank?, Member FDIC, pursuant to a license from Visa U.S.A. Inc. No cash access or recurring payments. Can be used everywhere Visa debit cards are accepted. Card valid for up to 12 months; unused funds will be forfeited at midnight EST the last day of the month of the valid thru date. Card terms and conditions apply; see site/visa-promo. Please allow up to 8 weeks for delivery of the rebate.

Revision #2

$500/$750 GM Visa? Prepaid Card Connect & Cruise Rebate Offer

Manual Powertrain System Offer Valid: 01/01/2018 - 12/31/2018

To receive your Visa prepaid card by mail follow these conditions of acceptance:

1) Purchase a Chevrolet Performance Crate Powertrain system between January 1, 2018 and December 31, 2018.

2) Complete all information requested on this form accurately and legibly. Make a clean, legible copy of the GM Dealer Invoice/Repair Order. The invoice must have the Dealer and eligible part purchases circled.

3) Submit your rebate on-line for faster processing or via mail. To submit on-line: Use a computer, tablet or mobile phone, go to and follow the instructions. You will be required to upload a copy of your Invoice/Repair Order. To submit via mail: Mail this form, along with a copy of your GM Dealer Invoice, to the address below. Submission must be postmarked by January 31, 2019.

4) By providing your contact information below, you consent that GM and/or a GM dealer can contact me with any GM offers and GM product information. For more information on the GM Privacy Statement please visit our website or call 1-866-MYPRIVACY (1-866-697-7482).

Mail to:

Connect & Cruise Powertrain Rebate Offer Number 66040 PO Box 6970 Mesa, AZ 85216

*First Name

Customer Information Section

*Last Name

*Denotes Required Field

*Address

*City

*State

*Zip Code

Email

Phone

(!) IMPORTANT: Photocopy your entire submission for your records. You may be required to mail or fax these photocopies.

*Dealer/Authorized Reseller Location

*Dealer/Authorized Reseller Zip Code

*Date of Purchase (MM/DD/YY)

*Invoice/Repair Order Number

Check the box next to the Model and corresponding 8 digit GM Part Numbers for the system purchased on your Invoice/Repair Order.

LS/LT

LS3 (6.2L) w/ T56 Manual Transmission $500 Rebate 19301326 19301625 19352208 19354328

LC3 (6.2L) - E-ROD w/ T56 Manual Transmission $500 Rebate 19257230 19301625 19352208

LT4 (6.2L) Wet w/ T56 Manual Transmission $500 Rebate 19368822 19329912 19368843 19352208

LS376/480 w/ T56 Manual Transmission $500 Rebate 19301358 19301625 19352208 19354330

LS376/515 w/ T56 Manual Transmission $500 Rebate 19301359 19301625 19352208

LS376/525 w/ T56 Manual Transmission $500 Rebate 19301360 19301625 19352208 19354332

LT4 (6.2L) Dry w/T56 Manual Transmission $500 Rebate 19332702 19329912 19368841 19352208

LSA (6.2L) - NON E-ROD w/ T56 Manual Transmission $750 Rebate 19331507 19329912 19352208 19354336

LSA (6.2L) - E-ROD w/ T56 Manual Transmission $500 Rebate 19357456 19329912 19352208

LS9 (6.2L) w/ T56 Manual Transmission $750 Rebate 19260165 19331083 19352208 19354338

LT376/535 (6.2L) w/T56 Manual Transmission $500 Rebate 19355378 19352208 12677124 19329912

LS7 (7.0L) w/ T56 Manual Transmission $750 Rebate 19329246 19301625 19352208 19354334

LT1 (6.2L) Wet w/T56 Manual Transmission $500 Rebate 19355405 19329912 19368833 19352208

LT1 (6.2L) Dry w/ T56 Manual Transmission $500 Rebate 19329997 19329912 19368831 19352208

Small Block

Ram Jet 350 (5.7L) w/ T56 Manual Transmission $750 Rebate 19355815 19329900 19352208

SP383 w/ T56 Manual Transmission $750 Rebate 19355722 19329900 19352208

SP350/357 T/K w/ T56 Manual Transmission $750 Rebate 19367084 19329900 19352208

SP350/385 T/K w/ T56 Manual Transmission $750 Rebate 19333158 19329900 19352208

ZZ427/480 w/ T56 Manual Transmission $500 Rebate 19331572 19329902 19352208

427 Anniversary w/ T56 Manual Transmission $750 Rebate 19166392 19329902 19352208

Big Block

ZZ454/440 w/ T56 Manual Transmission $500 Rebate 19331574 19329901 19352208

ZZ502 w/ T56 Manual Transmission $500 Rebate 19331579 19329901 19352208

Ram Jet 502 w/ T56 Manual Transmission $750 Rebate 12499121 19329901 19352208

ZZ572/620 Deluxe w/ T56 Manual Transmission $750 Rebate 19331583 19329902 19352208

All of the applicable 8 digit GM Part Numbers must be purchased on the same Invoice/Repair Order and must match what is checked on this form.

To check the status of your rebate visit "Status Lookup" at or call 844.656.5369 weekdays, 7 am to 11 pm Eastern Time. Please allow up to 8 weeks for rebate processing.

Offer valid for customers who make the purchase at a participating Chevrolet, Buick, GMC or Cadillac Dealer or Authorized Reseller located in the United States and U.S. territories. In order to receive the mail-in rebate debit card, qualifying purchases must satisfy the rebate requirements as outlined on this rebate application. Failure to meet the mail-in rebate requirements will disqualify your rebate. This offer is available to retail customers with mailing addresses in the United States and U.S. territories. This offer is not valid on products being replaced under warranty. Fleet and commercial customers and GM Company Vehicles are not eligible for this offer. Internal dealership sales are not eligible for this offer. This offer cannot be combined with other General Motors offers. Limit one (1) rebate per service performed per service date and vehicle and cannot be assigned or transferred. This offer is void where taxed, restricted or prohibited by law. General Motors and their partners are not responsible for lost, late, damaged, illegible, misdirected or postage-due submissions. Any excessive submissions, misrepresentation or fraudulent information disqualifies the rebate and may give rise to criminal or civil prosecution. All rebates shall be governed by applicable state and federal laws. All terms, conditions and rules of this program are subject to change. All submitted materials become property of General Motors and will not be returned. Rebate paid in the form of a Visa prepaid card. General Motors reserves the right to substitute a check of equal value in lieu of a Visa prepaid card at its discretion. Card is issued by MetaBank?, Member FDIC, pursuant to a license from Visa U.S.A. Inc. No cash access or recurring payments. Can be used everywhere Visa debit cards are accepted. Card valid for up to 12 months; unused funds will be forfeited at midnight EST the last day of the month of the valid thru date. Card terms and conditions apply; see site/visa-promo. Please allow up to 8 weeks for delivery of the rebate.

Revision #2

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