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Agri star II Cashback form
First Name
(Required)
Last Name
(Required)
Email Address
(Required)
Business Name
(Required)
Tyre Serial Numbers
(Required)
Number of Tyres
(Required)
Proof of purchase / Invoice
(Required)
Max. file size: 2 GB.
Account Number
(Required)
Sort Code
(Required)
I confirm all information provided is accurate and truthful. I confirm the tyres claimed belong to the legal entity named on the invoice. I confirm serial numbers submitted belong to the tyres purchased on the uploaded invoice. I understand fraudulent claims may result in permanent exclusion and recovery of funds. I accept the Terms & Conditions of the Agri Star II Cashback Promotion.
(Required)
I agree to the terms & conditions.
I confirm all information provided is accurate and truthful.
I confirm the tyres claimed belong to the legal entity named on the invoice.
I confirm serial numbers submitted belong to the tyres purchased on the uploaded invoice.
I understand fraudulent claims may result in permanent exclusion and recovery of funds.
I accept the Terms & Conditions of the Agri Star II Cashback Promotion.
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