All form submitted but company claims no record and it is not possible to contact them by phone or via computer.

I bought a Samsung Galaxy S5 phone at a Costco Kiosk on 11/25/2014 with two rebates promised to me totalling $80. I have only received $50 of it and Stuart Lee Rebates shows nothing in their records for the remaining $30. I sent both rebates in the same envelope so I know they received both of them as I did receive one for $50. I have tried to complain on their website and filled out all the information asked of them, however, there is no "send" button so I cannot actually send the complaint to them. I have filled this form out 7 times and have never had a way to send my complaint. They have a paragraph saying we can look for your rebate as soon as you fill out the form to the right and hit SEND. What a joke, There is no send button. I need this $30 in order to buy food.
I am disabled and live on Social Security which does not allow me to have money left over for food, gas or anything else. I have been in the hospital 3 times in the last 5 months as I am a diabetic with a kidney transplant. I cannot afford to lose $30. If may seem like nothing to some people, but every dollar means the world to me.

Please help me get my rebate back and shut this fraudulent company down.