Core Rebate Form Core Rebate FormTo be completed by an approved Authorized Fruitland DealerDealer Name(Required) Company Dealer Representative Name(Required) First Representative's Position Federal Tax ID of Dealer(Required) # Name of Pump Owner/End User(Required) First Last Name of who brought in the pumpEnd User's Email(Required) Name of Original Seller Company Original Seller's Address Street Address Address Line 2 City ZIP Code Vacuum Pump InformationDo you have the pump on hand?Yes, Pump is at Dealer LocationNo, Just The Oil Pump & Serial TagInformation of Used Pump You're Trading In(Required)Upload Picture of Pump's ID # or Oil Pump Serial #(Required) Drop files here or Select files Max. file size: 50 MB. New Pump Purchase You'd Like The Rebate To Go Towards(Required)RCF500RCF870RCF1400Consent(Required) I agree to the Fruitland's terms and conditions.Dealer(Required) I am an authorized Fruitland Dealer.CAPTCHA 79797
