If you are human, leave this field blank.Dealer NameDealer Email addressSalesperson NameCustomer NameModelSerial #Distributor Rep. NameInvoice #Invoice DatePlease select invoice date of unitAmountTotalImportant:Enviro units sold between March 1st 2012 and December 1st 2012 qualify within the terms of this promotion. – This form must be submitted to the distributor for approval, including proof of purchase for each unit claimed. – Salespersons may apply for a $40 Spiff for each Enviro unit sold within the terms of the promotion. – The Distributor will make payments within 30 days of application. Submit