Natural Gas Appliance Rebates

Rebates for natural gas appliances are provided by Atmos Energy Corporation (Atmos Energy) and
administered by Frontier Associates (Frontier). Eligible customers of Atmos Energy will receive rebate payments
issued by Frontier after receipt of all required customer documentation.
Gas furnaces, gas storage water heaters and tankless gas water heaters must be on an ENERGY
STAR list of approved products (available at www.energystar.gov) to qualify for rebate
payment. Gas dryers are not required to be on an ENERGY STAR list of approved products.

CUSTOMER INFORMATION

Rebate payments will be issued to eligible program applicants within approximately 4-6 weeks of receipt of
all required customer documentation. You can submit your rebate application two ways:
(1) Go to www.atmosenergy.com/efficiency to submit your application electronically.
(2) Or mail your rebate form and documents to:
Atmos Energy Natural Gas Appliance Rebates
1515 S. Capital of Tx Hwy., Ste 110, Austin, TX 78746
Check the status of your rebate application at www.atmosenergy.com/efficiency
Questions? Call 1-866-662-5279.
To receive rebates for more than one of the same type of equipment, please complete additional rebate forms.

EQUIPMENT INFORMATION

Excluding the City of Dallas

CHECKLIST
Incomplete rebate forms will not be accepted.
Make sure you:

Purchase and install equipment by June 30, 2016.

Include a copy of your dated receipt or contractor

invoice that details all installed equipment
information, including manufacturer model number .

Include a copy of your most recent Atmos Energy bill.

Complete, sign and date this form.

Maruthi Prasad Narasimha

Customer Name:______________________________________________________________________________________
4108 Remington Rd
Customer Address:_ ___________________________________________________________________________________
Cedar Park
TX
78613
City:_ __________________________________________________ State:_ _____________ Zip:______________________
(617) 347-7439
(617) 347-7439
Daytime Phone:______________________________________ Evening Phone:_ _____________________________________
maruthirpln@gmail.com
E-mail Address:_______________________________________________________________________________________
4001335046
Atmos Energy Customer Number:_ __________________________________________________________________________
Are you a residential or commercial customer?

ENERGY STAR Gas Furnaces

ACKNOWLEDGEMENT

NORTH & CENTRAL TEXAS

Residential

Rebate

Commercial

ENERGY STAR Gas Storage

Water Heaters

Rebate

90% to 94.9% AFUE

$350

40 gallon

$100

95% AFUE or greater

$500

50 gallon

$200

Manufacturer:_______________________________________

State Water Heater

Manufacturer:_______________________________________

Model #:__________________________________________

GS6-50-YOCT
Model #:__________________________________________

Serial #:_ _________________________________________

1251J0000890
Serial #:_ _________________________________________

ENERGY STAR Gas Tankless

Water Heaters
ENERGY STAR Gas Tankless Water Heater

Rebate
$300

Gas Dryers
Gas Dryer with moisture sensor

Rebate
$200

Manufacturer:_______________________________________

Manufacturer:_______________________________________

Model #:__________________________________________

Model #:__________________________________________

Serial #:_ _________________________________________

Serial #:_ _________________________________________

By signing below, the program applicant agrees and acknowledges that: (1) the equipment listed herein has been installed in compliance with all
state and local codes; (2) the equipment was bought and installed by June 30, 2016; (3) funding for the program is limited and eligible rebate
applications will be processed pending the availability of funds; (4) the program is subject to additional terms and conditions to be made available
on the website, and may change without notice to the program applicant; (5) the program applicant will permit access to installed equipment covered
under this program for inspection upon request by Atmos Energy or Frontier; (6) neither Atmos Energy nor Frontier shall have any liability relating to
the equipment, its installation or performance and (7) all information provided by program applicant in this application form is accurate.
Applicant Signature:_ ___________________________________________________________ Date:___________________
Copyright 2013-2014 Frontier

June 2015

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