OPALCO Appliance Rebate Application

Member Name

Account No.

Phone No.

Email Address

Site Installation Address

Street Address

City

State

Zip Code

Mailing Address (if different than Site Installation address)

Street Address

City

State

Zip Code

Date of Installation

Year Built

Size of Home (approximate)

Estimate the approximate size of the home in square feet.

Service Type

Rebate is for

Type of Home

Primary Electric Heat Source

Water Heat Source

Where did you hear about this program?

Do you live at this residence full-time? (Yes/ No)

If yes, how many permanent occupants in the home?

Income Qualified Energy Efficiency Measures

Does your household fall below 200% of the 2024 Federal Poverty Level?

1 Person: $30,120

2 People: $40,880

3 People: $51,640

4 People: $62,400

5 People: $73,160

6 People: $94,680

7 People: $94,680

8 People: $105,440

9 or more: Add $10,760 each

Yes

Please include a copy of the contractor’s invoice for proof of installation, including the date installed, appliance specifications, and model numbers.

Drop your files here

Terms & Conditions

Complete application must be received within 1 year of the installation date to be considered for incentive. Homeowners must comply with all applicable codes and regulations. Available to all active OPALCO members in good standing (no arrears balance). Rebates are only available to members in good standing. If member account is in arrears, the past due amount will be deducted from rebate amount. OPALCO reserves the right to inspect installation and will coordinate inspection as applicable. OPALCO is not responsible for any part of the appliance maintenance, power consumption, or any and all implied warranties (including but not limited to implied warranties or merchantability or fitness for a particular purpose) and shall not be responsible for any representation or promise with respect to the equipment, materials, or labor required for the installation of the appliance on the premises, or the cost of such equipment, materials and labor. Cannot be combined with other OPALCO rebate offerings. Additional conditions may apply. By signing below, the member implies that all information provided is true and accurate to the best of their knowledge.

Member Signature

Signature of Applicant

Signature Date (Applicant)

mm/dd/yyyy

New Appliance Information

Appliance Type

Purchase Date

mm/dd/yyyy

Quantity

Brand Name

Model No.

Second Appliance Type

Purchase Date for Second Appliance

Brand Name on Second Appliance

Model No. on Second Appliance

Total Installed Cost - Prior to Rebate ($)

Include cost for equipment, labor, electrical, tax, permit and other (prior to rebate).

Residential Appliances

- Appliances must be Energy Star Qualified - Appliances must be installed according to manufacturer's specifications - For a full list of available appliance rebates, please visit www.energysavings.opalco.com

Type of Business

Commercial Appliances

- For full list of available rebates, please contact (360) 376-3587.

**VOLUNTARY** Demographic Information

VOLUNTARY Demographic Information

Why do we ask? This information helps us access grants and other funding opportunities to better serve you!

Veteran?

YES

Disabled?

YES

Send me a copy of my responses

Report Abuse