X04/30/2010 $5/$10 or $10/$20 Heineken Shrimp, Seafood, or Seasonings NBPR: AL, AR, CT, HI, IN, KY, ME, MO, NC, NJ, NY, OK, UT, WV

[nateNnatsmommy]

Offer valid 03/01/2010 - 04/30/2010
Get up to $10
by mail with the purchase of $20 of shrimp (or any seafood) and/or seasonings AND one 12 pack or larger or one DraughtKeg of Heineken or Heineken Light or one 12 pack or larger of Amstel Light

OR

Get up to $5
by mail with the purchase of $10 of shrimp (or any seafood) and/or seasonings AND one 12 pack or larger or one DraughtKeg of Heineken or Heineken Light or one 12 pack or larger of Amstel Light

No beer purchase required in AL, AR, CT, HI IN, KY, ME, MO, NC, NJ, NY, OK, UT or WV

AL, AR, CT, HI, IN, KY, ME, MO, NC, NJ, NY, OK, UT and WV residents: to receive the $5 or $10 Heineken Shrimp & Seasonings Mail-In Rebate WITHOUT BEER PURCHASE, YOU MUST CHOOSE ONE OF THE FOLLOWING REBATE OPTIONS 1) Receive $5 by mail whenyou purchase at least $10 worth of shrimp (or any seafood) and/or seasonings OR 2) receive up to $10 by mail when you purchase at least $20 worth of shrimp (or any seafood) and/or seasonings and send this completed official mail in rebate offer form, the cutout of the original UPC code label for each qualifying product, and the original cash register reeipts(s) with item price(s) circled, to the address noted below. Indiana residents are eligible only for a $5 (not a $10) mail in rebate with a $10 purchase of products that are not alcoholic beverages if retailer does not carry seafood or seasonings.

Must be 21 or older to qualify for offer.

[saphira2021]

Question: on the form there is a field that says "Retailer Name (where you obtained this offer)"
what do i put in there? i got this in trade, the person who sent it to me, got it from Harris Teeter, but i bought it at Acme.
any ideas? TIA