Samsung Smart TV Reward Giveaway

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REWARD GIVEAWAY
Claim form

About your purchase

To claim your Samsung Reward, please complete and return this form. It s important that ALL fields marked*
are completed, as failure to do so may delay your claim.
Alternatively we recommend that you submit your claim online at: www.samsung.com/uk/tvrewardgiveaway
Completing the online form will ensure you receive your claim more quickly.
Completed forms must arrive no later than 28 days from the date of the additional products being purchased with a final closing date of 18th
February 2014. You are required to wait a minimum of 10 days after purchasing a Samsung Smart TV before making a claim. You will receive your Reward  back by cheque.

How did you hear about this promotion?* (please tick a box or boxes)
In store (please specify store name)

On www.samsung.com

Where was your purchase from* (please tick a box)
in store

or

online

If your purchase was in store, please specify store name and town
If your purchase was online, please specify the retailer s website

Samsung Smart TV model*

Social media

Value paid (£)*

TV serial number*

2nd product purchased* (e.g. Blu-ray player, washing machine)

On a retailer s website (please specify name of retailer)

Word-of-mouth

Date of purchase*

Value paid (£)*