Profit Source Publishing
ClickBank Order Up To 37% Rebate Form

Profit Source Publishing will rebate up to 37% of the purchase price of your ClickBank purchase made from our website.  Your actual rebate will vary depending upon the purchase price and commission percentage paid by ClickBank to Profit Source Publishing.  Average product rebates are 25%.  To qualify for your rebate, your computer should accept cookies during the ClickBank order process so you will see a notation at the bottom of your credit card entry page stating (affiliate=psprpspr).*

Rebate checks are mailed by 1st Class or Airmail U.S. Mail after the 90 day refund period has ended and you have NOT requested or received a refund for the item.  If you provide a PayPal Email address below, your rebate will be delivered directly to your PayPal account after the refund period.

To receive your rebate, complete the following information:  (Please Print)

Order Date:__________________ 

Name On Order:______________________________________________

Click Bank Order Number:______________________________________ 
(See your ClickBank email receipt)

Item Name:____________________________Item Price:______________ 

Mailing Address:_______________________________________________ 



PayPal Email:_________________________________
(Optional for rebate payment by PayPal)
*Profit Source Publishing reserves the right to refuse rebate payment for items that have not resulted in a ClickBank commission payment to Profit Source Publishing (affiliate=psprpspr). This offer may be withdrawn at any time.

. FAX or Print & Mail To:
Profit Source Publishing
Post Office Box  1366
Windermere, FL 34786 USA
FAX: (407) 650-2568