Full Name:
Address:
ZIP:
Phone (include area code):
E-mail:

Planters VISA® Check Card must be registered with UChoose Rewards to be eligible for prizes. Registration is free. Visit www.uchooserewards.com to register. • The winner of the Million Points prize will be chosen by random drawing from all eligible entries received. Odds of winning depend upon total number of signature-based transactions conducted using Planters VISA® Check Cards and single entries registered with UChoose Rewards between May 14 and September 14, 2012. • All awards subject to 1099-MISC reporting. Any taxes are the recipient's responsibility. • Member FDIC