Appliance Rebate Application Form 1-2009

Concord Municipal Light Plant Appliance Rebate Form

Name of Appliance(s) (please include brand and model #):

________________________________________________________ ________________________________________________________ Your name: ______________________________________________ Account number: __________________________________________ Address: ________________________________________________

________________________________________________________ Phone #: _________________________________________________ Email: ___________________________________________________ Signature: ________________________________________________

Please mail completed form, the yellow Energy Guide containing the

Energy Star label and a copy of the sales receipt to: Appliance Rebate Program Concord Municipal Light Plant PO Box 1029 Concord, MA 01742 Eligible Energy Star rated appliances must have been purchased after Jan 1, 2009 and include: • • • • •

refrigerators/freezers - $100 washing machines - $50 dehumidifiers - $50 dishwashers - $50 room a/c units - $50