This rebate offer is good for purchase of new ENERGY STAR
certified product(s). Restrictions apply, as noted. This offer is
available to customers of partici-pating municipal electric
utilities listed on the back of this form. Equipment must be
installed in a residence served by a participating electric
utility. Exte-rior installations do not qualify. Equipment must not
be used to qualify and receive payment for energy savings from any
wholesale electricity market.
To receive rebate, mail completed application, along with your
dated sales receipt, to your participating municipal utility, or
email to [email protected]. Applications must be
postmarked within 90 days of purchase. Incomplete information will
delay or disqualify your rebate. If you do not receive your rebate
within eight weeks, please call your participating utility. Utility
may conduct an inspection to verify installed equipment.
This rebate program is reviewed and authorized each year for
incentives that are available from January 1 through December 31.
This rebate offer is availa-ble on a first-come, first-served
basis, and can be changed or withdrawn at any time without notice.
The utilities do not warrant the performance of installed equipment
expressly or implicitly. Offer is subject to change without prior
notice. Void if copied or transferred or where prohibited by law.
One rebate per product purchased. Rebate will not exceed purchase
cost of equip-ment. Not responsible for lost, late, or undelivered
responses. This form has no cash value. Please retain a copy for
your records.
Any use of this rebate or form except as described herein
constitutes fraud. Fraudulent submissions could result in federal
prosecution under U.S. Mail Fraud Statute (18 U.S. Code, Section
1241 and 1242). Please dispose of used appliances in an
environmentally friendly way.
IMPORTANT: All products must be ENERGY STAR® certi-fied. LED
rebate applications must include original pack-aging or photo of
packaging showing ENERGY STAR® logo.
Ver Web1.1 GAS 2019-0129
Getting a rebate is easy! Submit completed application and a
copy of your dated sales receipt to your electric utility within 90
days of purchase by:
1. Clicking Email button at top of page (attach receipts,
please); or,
2. Printing form and mailing to utility address on Page 2.
ENERGY STAR® Rebates
Bright Energy Solutions® 2019
→ LED screw-in bulbs—$1.50 ea:
BRAND MODEL
NUMBER
PURCHASE
DATE QTY
TOTAL QTY
First Name Last Name Email Address Phone
Equipment Installation Street Address City Mailing Address (if
different) ZIP City State
Account Number Signature Electric Utility Name
→ LED recessed can fixture or retrofit kit - $4….
→ Refrigerator (Min. 7.5 cu. ft.) - $25…………………...
→ Dehumidifier - $25……………………………………….
→ Room air conditioner - $25…………………………..
→ Clothes washer - $25*
Purchase Date Serial Number Model Number Brand Name
Purchase Date Serial Number Model Number Brand Name
Purchase Date Serial Number Model Number Brand Name
Purchase Date Serial Number Model Number Brand Name
Purchase Date Model Number Brand Name Quantity
*To qualify for washer rebate, your water heater fuel
(electricity or natural gas) must be provided by the participating
utility.
Water-heater fuel source: Other Gas Propane Electric
Clothes dryer fuel source: Gas Propane Electric
NUMBER 1: NUMBER 2: NUMBER 3: DATE 1: DATE 2: DATE 3: 1: 2: 3:
1_2: 2_2: 3_2: 4: Brand Name: Model Number: Purchase Date:
Quantity: Brand Name_2: Model Number_2: Serial Number: Purchase
Date_2: Brand Name_3: Model Number_3: Serial Number_2: Purchase
Date_3: Brand Name_4: Model Number_4: Serial Number_3: Purchase
Date_4: Brand Name_5: Model Number_5: Serial Number_4: Purchase
Date_5: Last Name: First Name: Phone: Email Address: Equipment
Installation Street Address: City: Mailing Address if different:
City_2: State: Electric Utility Name: Account Number: Text12:
Text13: Check Box14: OffCheck Box15: OffCheck Box16: OffCheck
Box17: OffCheck Box18: OffCheck Box19: OffCheck Box20: OffEmail:
print:
