NAME :

______________________________________

ADDRESS :

______________________________________

______________________________________

CITY :

______________________________________

PROVINCE :

______________________________________

POSTAL CODE :

______________________________________

Regular PHONE :

______________________________________

______________________________________

OFFER DATE:

September 1, 2006   to   September 30, 2006

October 16, 2006

PROOF OF PURCHASE REQUIREMENTS:

MAIL ALL OF THE ABOVE TO:

Offer is open to Canadian residents only. One claim per household. In order to qualify for this rebate you must subscribe to one of XLVOX Inc.  voice over IP products  by September 30, 2006.  Claim will be void if postmarked after October 16th, 2006. No responsibility will be taken for lost, misdirected, illegible or delayed claims. Claims must be made using this official claim form which is to be fully completed. Missing information will delay offer fulfillment. After affixing proper postage, mail completed claim form and copy of Subscription Confirmation Form to the claim address. You may wish to use registered mail. Allow 8 weeks for delivery of your rebate cheque. No substitution of offer allowed. Any late submissions or incomplete claims will be considered null and void. No exceptions will be made.  Void where prohibited, taxed or otherwise restricted by law. Offer good in all provinces across Canada. This promotional offer may not be used in conjunction with other XLVOX offers. All taxes are included in values. If you have any questions call 1-866-83-XLVOX.