High Eff Furnace Rebate Application

Residential High-Efficiency Natural Gas Furnace Rebate MichCon Pilot Program 2008-2009 APPLICATION Homeowner Name: Street Address: City: Mailing Address if Different – Street: City: Telephone:

State:

State: e-Mail: Old Furnace – Make/Brand and Estimate of Age:

MichCon Account Number: Heating Contractor: Installation Date: Furnace Model No: GAMA Efficiency: Describe any additional options installed with furnace:

Zip:

Zip:

New Furnace Make: Furnace Size (BTU):

Signature: Date: MichCon Rcvd Date:

MichCon Action:

Complete this Form and mail with a copy of the furnace installation invoice, dealer sizing worksheet and furnace efficiency certification to Bob Fegan, DTE Energy/MichCon at: [email protected] -or4420 44th Street SE Suite B, Grand Rapids, MI 49512 -orfax to 616-954-4574 with a Cover Page ‘Attention Bob Fegan’ Application MUST include: 1. 2. 3. 4.

April 2008

This completed Form Copy of furnace/installation invoice Copy of dealer’s furnace sizing worksheet Proof of furnace efficiency/dealer statement of furnace efficiency per GAMA