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Mobil submission form

To receive your e-gift card, simply complete the form below and upload your purchase receipt (from participating installers) dated between March 1, 2019, and October 31, 2019, with eligible oil change circled.

All requests must be submitted by November 30, 2019. All fields are required.

Contact information

First name
Last name
Address
City
Province
Postal code
Phone
Email address
Confirm email

Oil change information

Oil change facility

Lookup the oil change facility that performed your oil change. If the location you received your oil change from is not shown, please email

Lookup
Oil purchased
 

Date of oil change
Cost of oil change (including tax)
Proof of purchase

Please upload a clear photo of your entire store receipt with purchase price circled.
(JPG or PNG or PDF, max filesize 8MB)

 

Which e-gift card do you want to receive?

 
 
 
 
 
 
 

* Restrictions apply, see Amazon.ca/GC-legal.