State Rebate Requests

NOTICE
NORA requires samples of the finalized project materials.
There are fields to provide either a sample (pdf), or a link to the sample.

For NORA approved trade associations to request payment to contractors or other service providers for approved projects that benefit the industry, please completely fill out and submit this form.

You can include up to three projects with each submitted request as long as the payment is to one party (vendor or association).

This is a multi-page form. Click “Next” at the bottom of each page.

Please note: no single document upload can exceed 3 MB. File formats accepted: jpg, jpeg, png, gif, xls, xlsx, pdf, tif, tiff, csv

Rebate Payments Form

Date: *

PIN*

Association Name*

Name*

First

Last

Phone

Email*

You may enter up to three projects as long as the payment will be made to a single recipient.

Project Categories: CE=Consumer Education, EE=Energy Efficiency, ET=Education & Training, RD&D=Research Development & Demonstration

FIRST Project Amount $*

Select FIRST Project Type*

FIRST Project Summary*

Upload Detailed FIRST Project Description

Upload FIRST Project Vendor Invoice (pdf only)*

NORA requires a sample of the final product. You can either upload a sample or provide a link below.

Upload First Project Sample

Provide Link to First Project Sample

Project Categories: CE=Consumer Education, EE=Energy Efficiency, ET=Education & Training, RD&D=Research Development & Demonstration

Don't have a second submission? Click NEXT.

SECOND Project Amount $

Select SECOND Project Type

SECOND Project Summary

Upload Detailed SECOND Project Description

Upload SECOND Project Vendor Invoice (pdf only)

NORA requires a sample of the final product. You can either upload a sample or provide a link below

Upload Second Project Sample

Provide Link to Second Project Sample

Project Categories: CE=Consumer Education, EE=Energy Efficiency, ET=Education & Training, RD&D=Research Development & Demonstration

Don't have a third submission? Click NEXT.

THIRD Project Amount $

Select THIRD Project Type

THIRD Project Summary

Upload Detailed THIRD Project Description

Upload THIRD Project Vendor Invoice (pdf only)

NORA requires a sample of the final product. You can upload a sample or provide a link below.

Upload Third Project Sample

Provide Link to Third Project Sample

Total Requested*

Payment to*

Vendor*

Vendor Contact*

First

Last

Vendor Address

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code

Upload Vendor 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

State Rebate Requests

NOTICE
NORA requires samples of the finalized project materials.
There are fields to provide either a sample (pdf), or a link to the sample.

This is a multi-page form. Click “Next” at the bottom of each page.

Important

When submitting for consumer equipment/tank rebates,
please use the new short form.

Consumer Equipment/Tank Rebate Request Short Form

For all other project rebates, continue to use this form.

State Rebate Requests

NOTICENORA requires samples of the finalized project materials. There are fields to provide either a sample (pdf), or a link to the sample.

This is a multi-page form. Click “Next” at the bottom of each page.

NOTICE
NORA requires samples of the finalized project materials.
There are fields to provide either a sample (pdf), or a link to the sample.