Tidweb Res Solar Rebate App P1

SOLAR INCENTIVE APPLICATION

NAME (AS IT APPEARS ON YOUR ELECTRIC BILL) ADDRESS (WHERE ITEMS WILL BE INSTALLED)

APPLICATION DATE

TID ACCOUNT NUMBER

TELEPHONE NUMBER

SOLAR RETAILER NAME OF COMPANY

BUSINESS RESALE NUMBER

MAILING ADDRESS OF COMPANY CITY

TELEPHONE NUMBER STATE

ZIP CODE

INSTALLER (IF DIFFERENT FROM RETAILER) CONSTRUCTION CLASS & LICENSE #

NAME OF COMPANY MAILING ADDRESS OF COMPANY

CITY

TELEPHONE NUMBER STATE

ZIP CODE

WHO SHOULD RECEIVE THE REBATE? CIRCLE ONE

PURCHASER

RETAILER

REBATE RECIPIENTS SOCIAL SECURITY NUMBER OR FEDERAL TAX ID NUMBER

SOLAR SYSTEM PHOTOVOLTAIC MODULE MANUFACTURER

MODULE MODEL NUMBER

PTC MODULE POWER RATING TOTAL ARRAY OUTPUT (NUMBER OF MODULES * PTC MODULE POWER RATING)

INVERTER MANUFACTURER

INVERTER MODEL NUMBER

PEAK INVERTER EFFICIENCY SYSTEM RATED AC OUTPUT (TOTAL ARRAY OUTPUT * PEAK INVERTER EFFICIENCY)

SYSTEM COST (COST OF SYSTEM BEFORE INCENTIVE)

INCENTIVE (INCENTIVE AMOUNT * SYSTEM RATED AC OUTPUT)

IF YOU HAVE ANY QUESTIONS OR NEED ASSISTANCE, PLEASE CALL 883-8506.

SOLAR INCENTIVE APPLICATION TERMS AND CONDITIONS The undersigned declares under penalty of perjury that: 1) The purchaser has read and understands the Program Eligibility Criteria and Requirements; 2) The information provided to apply for this Solar Incentive is true and correct; 3) The above-described generating system is intended primarily to offset part or all of the electrical needs at the site of installation; 4) The site of the installation is located within the electric service territory of the Turlock Irrigation District; 5) The purchaser understands that program funds are subject to change and not reserved until TID deems the project application complete and the purchaser receives a Solar Incentive Program reservation letter from TID. 6) The purchaser agrees that the selection, purchase, and ownership of the equipment are their sole responsibility. TID makes no representation as to the safety, reliability, and/or efficiency of the equipment selected or components thereof. TID makes no warranty, whether expressed or implied, including warranty of merchantability or fitness for any particular purpose, use, or application of the equipment. 7) The purchaser acknowledges receipt of Turlock Irrigation District Electric Service Rule 22 and agrees to comply with its terms. The Customer acknowledges that the TID Board of Directors may amend Rule 22 at any time and the Customer agrees to be bound by all subsequent amendments of this Electric Service Rule while his or her solar facilities are subject to an Interconnection Agreement with TID. (Customer to INITIAL) 8) The purchaser acknowledges receipt of TID’s NET rate schedule and wishes to be placed on this rate schedule upon completion and approval of his or her solar installation. All TID rate schedules are subject to change. 9) The purchaser acknowledges that by accepting a Solar Incentive Payment from TID, the purchaser agrees that TID

may count 100% of the Renewable Energy Credits (RECs) and associated renewable attributes generated by the PV system for reporting purposes.

CUSTOMER SIGNATURE

DATE

PRINT NAME & TITLE (IF BUSINESS APPLICATION)

TAX LIABILITY YOU ARE URGED TO CONSULT YOUR TAX ADVISOR CONCERNING THE TAXABILITY OF REBATES. TID IS NOT RESPONSIBILE FOR ANY TAXES THAT MAY BE IMPOSED AS A RESULT OF YOUR RECEIPT OF THIS REBATE. CUSTOMER SIGNATURE

PRINT NAME

DATE