Consumer Equipment Rebate Request

Use this form when submitting for consumer equipment/tank rebates.

For all other rebates, use this form.

Consumer Equipment Rebate Form

Date: *

PIN*

Association Name*

Name*

First

Last

Phone

Email*

Please select *

Total Requested*

Upload Rebate Spreadsheet*

Upload supporting documentation (if needed)

Payment to (choose from drop-down)*

If payment to service/install company, upload W-9

This is for an oil efficiency and upgrade program and I certify that to the maximum extent practicable, I have coordinated, developed and implemented this project with the state energy efficiency administrator.*

Yes

I hereby declare the the funds were used in accordance with the National Oilheat Research Act of 2000.*

Yes

I have read, understand and agree to comply with NORA State Rebates Terms & Conditions.*

Yes

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