Citi^® Driver's Edge^® Vehicle Redemption Form

Within 90 days of your vehicle purchase or lease date, return this completed form to the address below along with a copy of your proof of purchase or lease.

The redemption will be for a minimum of $25 and a maximum of the vehicle purchase price or lease amount.
Only one redemption can be submitted per vehicle.
Please allow 3 weeks for receipt, review and processing.
Once approved, a check will be mailed. Any documents you submit cannot be returned.

About You^*

First Name

Last Name

Street Address

Street Address 2 (optional)

City

State/Territory

Zip Code

Citi Driver's Edge Account Number

About Your Vehicle

I'm redeeming for:

Purchase

Lease

Date of Purchase or Lease

Manufacturer

Model Year

Model

Amount Paid for Vehicle

Purchase/Lease From a Dealership

As proof of purchase/lease, I have enclosed one of the following^* (select one):

Bill of Sale

Retail Installment Contract (must be signed by you and the dealer)

Purchase Order/ Buyer's Order (must be signed by you and the dealer)

Lease Agreement

Application for Title (must show the amount you paid for the vehicle)

Purchase From a Private Seller

As proof of purchase, I have enclosed both items listed below:

Registration or Title

Proof of Payment or Bill of Sale with previous owner's signature

I Am Redeeming For

Select one:

Myself

An authorized user on my account

A household member

I certify that either an authorized user on my account, a household member, or myself, have purchased or leased an eligible vehicle referenced in the attached documentation. I understand the check will be made out to me, the Primary Cardmember.

Primary Cardmember Signature

Date

Mail completed form within 90 days of purchase or lease to:

Citi Driver's Edge Redemption Center
P.O. Box 6097
Sioux Falls, SD 57117–6097

You may call 1-800-308-4158 (8AM – 9PM Central Time) (TTY/TDD: 1–800–325–2865)

^*Citibank reserves the right to request additional information prior to processing.

Citi® Driver's Edge® Vehicle Redemption Form