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Washer & Dishwasher Application

Washer & Dishwasher Application 2010 Iowa Application Purchase an ENERGY STAR® qualified clothes washer and /or
Washer & Dishwasher Application 2010 Iowa Application Purchase an ENERGY STAR® qualified clothes washer and /or

2010 Iowa Application

Washer & Dishwasher Application 2010 Iowa Application Purchase an ENERGY STAR® qualified clothes washer and /or

Purchase an ENERGY STAR® qualified clothes washer and /or an ENERGY STAR qualified dishwasher and receive a rebate from Black Hills Energy.

STAR® qualified clothes washer and /or an ENERGY STAR qualified dishwasher and receive a rebate from
STAR® qualified clothes washer and /or an ENERGY STAR qualified dishwasher and receive a rebate from
Full-sized ENERGY STAR qualified clothes washers save you time and money. Compared to traditional washers,

Full-sized ENERGY STAR qualified clothes washers save you time and money. Compared to traditional washers, ENERGY STAR washers use less water per load, and extract more water during the spin cycle meaning less drying time.

more water during the spin cycle meaning less drying time. ENERGY STAR qualified dishwashers use 31

ENERGY STAR qualified dishwashers use 31 percent less energy and 33 percent less water than conventional machines while delivering superior cleaning performance.

2010 ioWa rEBatE appliCation
2010 ioWa rEBatE appliCation

CUSTOMER INFORMATION

Account Number

(Located in top-right corner of Black Hills Energy natural gas bill)

Name on Account

q

New Home

q Existing Home

 

Home Address

 

City

State

Zip

Day Telephone (

)

Evening Telephone (

 

)

E-mail

 

Name of Builder (If new home)

Where did you learn about our rebates? q Radio

q

Print Ad q Newspaper Article q Bill insert

q

Word of Mouth: referral by

q

E-mail q Event q Billboard q Flyer

q

Other

CUSTOMER AGREEMENT

I certify that all equipment listed has been purchased

and installed at the installation address indicated. I agree

to the terms and conditions in this brochure. Black Hills

Energy reserves the right to inspect installation before

and/or after paying rebates.

Customer Signature

Date

include a copy of original invoice to qualify for washer and/or dishwasher rebate.

ENERGY STAR qualified washer (MEF ≥ 1.8 and WF ≤ to 7.5)

$100

ENERGY STAR qualified standard dishwasher (EF ≥ 0.65)

$20

MEF (modified energy factor) WF (water factor) EF (energy factor)

tErms and Conditions
tErms and Conditions

n

Applicant must be a current Iowa Black Hills Energy residential customer and have a natural gas water heater.

n

Purchase and installations must be completed between Jan.1, 2010 and Dec. 31, 2010.

n

Applications and receipts or supporting documentation must be received by Jan. 31, 2011.

n

This program is subject to regulatory rules and orders, and Black Hills Energy reserves the right to change or to end any portion of this program without notice.

Building information
Building information

Year Built

Building Square Footage

Space Heating Type:

q

Forced Air Furnace

q

Boiler

q

Electric Heat/Other

Does home have central air?

q Yes

q No

Approximate Age of Unit

 

Water Heating Fuel:

 

q

Natural Gas

q Electric

q Other

Clothes Dryer Fuel:

 

q

Natural Gas

q Electric

q Other

q N/A

EquipmEnt information
EquipmEnt information

ENERGY STAR WASHER

Installation Date

Brand

Model #

Serial #

ENERGY STAR DISHWASHER

Installation Date

Brand

Model #

Serial #

rEBatE ChECklist
rEBatE ChECklist

Get your rebate faster by checking off these easy steps before mailing your application form. Incomplete and inaccurate application forms will slow down the rebate process.

q

application must be completely filled out

q

All receipts attached

q

Reviewed Terms and Conditions and signed and dated application

q

Made copies of all documents and application for your records

q

Sent all documents to correct address listed on application

For more information or questions regarding the rebate programs available through Black Hills Energy visit www.BHEhowto.com or call our toll-free number at

888-567-0799.

In addition to the rebates that Black Hills Energy offers, the federal government is now offering a tax credit of 30 percent, up to $1,500 total, to help increase the energy efficiency of your home. These programs are available for a limited time so act now. Visit www. energystar.gov/taxcredits for details or consult a tax advisor.

Mail completed application and itemized invoice to: Black Hills Energy c/o Energy Efficiency Program PO
Mail completed application and itemized invoice to:
Black Hills Energy
c/o Energy Efficiency Program
PO Box 7390
Des Moines, IA 50309
ADDITIONAL INFORMATION
For more information or to download additional applications
visit www.BHEhowto.com or call our toll-free
Energy Efficiency hotline at 888-567-0799.

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