$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

*First Name

*Denotes Required Field

*Last Name

*Address

*City

*State

Email

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.

Big Block

Small Block

LS

? 350/290 Deluxe w/ 4L65E Transmission

$500 Rebate

? 19355659 ? 19332781

? 19368611 ? 19299800

? 19332775

? SP350/357 Turn-Key w/ 4L65E Transmission

$500 Rebate

? 19367084 ? 19332781

? 19368611 ? 19299801

? 19332775

? LS 376/515 w/ 4L70E

Transmission

$500 Rebate

? 19301359

? 19259117

? 19368613

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

$500 Rebate

$500 Rebate

? 19332775

? 19355662 ? 19332781

? 19333158 ?19332781

? 19368611 ? 19299800

? 19368611 ?19299801

? 19332775

? 19332775

? ZZ427/480 w/ 4L70E Transmission

$500 Rebate

? 19331572 ? 19332781

? 19368613 ? 19299801

? 19332775

? 502 HO w/ 4L85E Transmission

$500 Rebate

? 12568778 ? 19332784

? 19300175 ? 19299804

? 19332780

? 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

$500 Rebate

? 19331574 ? 19332784

? 19300175 ? 19299804

? ZZ572/620 Deluxe w/ 4L85E Transmission

$750 Rebate

? 19331583 ? 19332784

? 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

$500 Rebate

? 19333157 ? 19332781

? 19368611 ? 19299801

? 19332775

? ZZ6 Turn-Key w/ 4L65E Transmission

$500 Rebate

? 19351533

?19332781

? 19368611

?19299801

? 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

Customer Information Section

*First Name

*Denotes Required Field

*Last Name

*Address

*City

*State

Email

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.

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

? LSA (6.2L) NON E-ROD w/ 4L85E Transmission

$750 Rebate

? 19331507 ? 19299806

? 19300175 ? 19259119

? 19302410

? LT1 (6.2L) Wet Sump w/ 4L70E Transmission

$500 Rebate

? 19355405 ? 19299802

? 19368833 ? 19302405

? 19368614 ? 19329416

? LT4 (6.2L) Dry Sump w/ 4L75E Transmission

$500 Rebate

? 19332702 ? 19368615

? 19368843 ? 19299802

? 19329416 ? 19302405

? LT1 (6.2L) E-ROD Wet Sump w/ 4L70E Transmission

$500 Rebate

? 12682080 ? 19302405

? 19368614 ? 19329416

? 19299802

? LT4 (6.2L) Wet Sump w/ 4L75E Transmission

$500 Rebate

? 19368622 ? 19368615

? 19368843 ? 19299802

? 19329416 ? 19302405

? LT1 (6.2L) w/ 8L90E Transmission

$500 Rebate

? 19355405 ? 19367134

? 19368835 ? 24283284

? LT4 (6.2L) Wet Sump w/ 8L90E Transmission

$500 Rebate

? 19368622 ? 19367135

? 19368845 ? 24284144

? LT376/535 w/ 4L75E Transmission

$500 Rebate

? 19355378 ? 19299803

? 19368837 ? 19302405

? 19329416

? 19368615

? LSA (6.2L) E-ROD w/ 4L85E Transmission

$750 Rebate

? 19257456 ? 19300175

? 19259119 ? 19299806

? 19302410

? LSA (6.2L) E-ROD w/ 4L75E Transmission

$750 Rebate

? 19257456 ? 19368615

? 19299802 ? 19302405

? 19259117

? 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

Customer Information Section

*First Name

*Denotes Required Field

*Last Name

*Address

*City

*State

Email

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.

LS/LT

? LS3 (6.2L) w/ T56 Manual Transmission

$500 Rebate

? 19301326 ? 19301625 ? 19352208

? 19354328

? LS376/480 w/ T56 Manual Transmission

$500 Rebate

? 19301358 ? 19301625 ? 19352208

? 19354330

? LSA (6.2L) - NON E-ROD w/ T56 Manual Transmission

$750 Rebate

? 19331507 ? 19329912 ? 19352208

? 19354336

? LC3 (6.2L) - E-ROD w/ T56 Manual Transmission

$500 Rebate

? 19257230 ? 19301625 ? 19352208

? LS376/515 w/ T56 Manual Transmission

$500 Rebate

? 19301359 ? 19301625 ? 19352208

? LSA (6.2L) - E-ROD w/ T56 Manual Transmission

$500 Rebate

? 19357456 ? 19329912 ? 19352208

? LT4 (6.2L) Wet w/ T56 Manual Transmission

$500 Rebate

? 19368822 ? 19329912

? 19368843 ? 19352208

? LS376/525 w/ T56 Manual Transmission

$500 Rebate

? 19301360 ? 19301625 ? 19352208

? 19354332

? LS9 (6.2L) w/ T56 Manual Transmission

$750 Rebate

? 19260165 ? 19331083 ? 19352208

? 19354338

? LT4 (6.2L) Dry w/T56 Manual Transmission

$500 Rebate

? 19332702 ? 19329912

? 19368841 ? 19352208

? LT376/535 (6.2L) w/T56 Manual Transmission

$500 Rebate

? 19355378 ? 19352208

? 12677124 ? 19329912

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

? 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

Big Block

? ZZ427/480 w/ T56 Manual Transmission

$500 Rebate

? 19331572

? 19329902

? 19352208

? ZZ454/440 w/ T56 Manual Transmission

$500 Rebate

? 19331574

? 19329901

? 19352208

? Ram Jet 502 w/ T56 Manual Transmission

$750 Rebate

? 12499121

? 19329901

? 19352208

? 427 Anniversary w/ T56 Manual Transmission

$750 Rebate

? 19166392

? 19329902

? 19352208

? ZZ502 w/ T56 Manual Transmission

$500 Rebate

? 19331579

? 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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