MIDWESTWHEEL.COM MEMBER KANSAS CITY 5801 E. Front St. Main ....(816) 471-1552 Parts....(800) 821-7402 JOPLIN 2424 Stephens Blvd. Main ....(417) 717-6022 Parts....(866) 318-9111 SPRINGFIELD 812 Lillian Dr. ∙ Strafford, MO Main ....(417) 429-2476 Parts....(800) 785-3705 SIOUX CITY 1819 4th St. Main ....(712) 252-7969 Parts....(800) 943-3534 CEDAR RAPIDS 200 50th Ave. S.W. Main ....(319) 365-4453 Parts....(800) 332-5435 DES MOINES 1436 E. Ovid Ave. Main ....(515) 265-1491 Parts....(800) 888-0248 CLEAR LAKE 840 Hwy. 18 W. Main ....(641) 357-7101 Parts....(800) 397-5630 DAVENPORT 8502 Northwest Blvd. Main ....(563) 322-2671 Parts....(800) 553-1886 OMAHA 9770 S 142nd Street, Suite 1 Main ....(531) 239-3050 Parts....(800) 322-8757 NEBRASKA IOWA MISSOURI April 16, 2024 (28AirLift Installer Spiff Kick Off) Distributor Invoice Date: Invoice #: Air Lift Part #: Quantity: Distributor Name: PARTICIPANT NAME: PARTICIPANT MAILING ADDRESS: PARTICIPANT CITY: STATE/PROVINCE: ZIP/POSTAL CODE: PARTICIPANT EMAIL: PARTICIPANT PHONE: SHOP NAME: SHOP PHONE: SHOP ADDRESS: SHOP CITY: STATE/PROVINCE: ZIP/POSTAL CODE: Complete the below form and mail it, along with all supporting documentation to: Air Lift Authorized Installer Rebate Program 2024 Dept. 13437 • PO Box 5018 Stacy, MN 55078-5018 Mail-in Submission All fields on the submission form must be completed to be processed. Claims must be submitted by mail with supporting documentation and postmarked by June 30, 2024. AUTHORIZED INSTALLER EMPLOYEE REBATE PROGRAM Complete this form in its entirety. Then, send the completed form and invoices from Air Lift wholesale accounts dated between April 15 and May 31, 2024, in the same envelope to the above address. All submissions must be postmarked by June 30, 2024. 2
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