Hvac New Equipment Application Instructions Sheet (Page 2 of 3) in pdf

Heating & Cooling New Equipment Rebate Application

for Residential Electric Customers

presented by

Applicant Information

Rebate will be paid to SCE&G account holder by default. If the owner of the property is to be paid but is not the

account holder, please include an IRS Form W9, available at:

SCE&G ELECTRIC ACCOUNT HOLDER: ______________________________________________ TELEPHONE: ___________________________________

INSTALLATION ADDRESS: ____________________________________________________________________________________________________

CITY: _______________________________STATE: ________ ZIP: ______________ EMAIL: ______________________________________________

SCE&G ELECTRIC ACCOUNT NUMBER:

HOMEOWNER’S NAME: (If different than Account Holder) _____________________________________________________________________________

HOME TYPE: (Check One) q SINGLE FAMILY q APARTMENT q CONDO q MOBILE HOME

HOME SIZE: _________ SQ. FT.

YEAR BUILT: _________

Installer Information

TECHNICIAN NAME: _______________________________________________________ TELEPHONE: _______________________________________

COMPANY NAME: __________________________________________________________________________________________________________

ADDRESS: _______________________________________________________________________________________________________________

CITY: _______________________________STATE: ________ ZIP: ___________ INSTALLER SIGNATURE: _____________________________________

INSTALL DATE: _____________________________________ MECHANICAL LICENSE NUMBER: ______________________________________________

New Equipment

NEW EQUIPMENT TYPE MUST BE THE SAME AS REMOVED EQUIPMENT TYPE TO BE ELIGIBLE FOR THIS REBATE

(Central air conditioners must be replaced by central air conditioners and heat pumps must be replaced by heat pumps.)

Minimum Ratings

Quantity

System Type

Rebate

AHRI Number(s)

Installed

SEER

EER

HSPF

12.5

❏ $200

Split

❏ $400

Air Conditioner

❏ $200

Packaged

❏ $400

❏ $200

12.5

8.5

Split

❏ $400

Heat Pump

8.2

❏ $200

Packaged

8.5

❏ $400

Removed Equipment

System Type

Heating Fuel Type

Size

Age

Condition

SEER

(tons)

q Split

q Operating

q Air Conditioner

q Electric

q Gas

q Dual-Fuel

q Packaged

q Failed

q Split

q Operating

q Heat Pump

q Electric

q Gas

q Dual-Fuel

q Packaged

q Failed

ACCEPTANCE OF TERMS

I hereby certify that I am the SCE&G electric account owner and/or the owner of the facility/address at which the service/installation occurred, that I have purchased the equipment described on this rebate

application, and that it has been installed at the indicated installation address. I have read and accept the Terms and Conditions on the reverse side of this form and acknowledge that SCE&G may verify the

information provided. A copy of the detailed installation invoice with the date of purchase must accompany this form. The Applicant agrees to conduct this transaction by written or electronic means, including

but not limited to the acknowledgement above of having read and agreeing to the Terms and Conditions of this rebate program.

APPLICANT SIGNATURE: ______________________________________________________________________________________ DATE: __________

PLEASE READ THE INFORMATION ON THE REVERSE SIDE BEFORE COMPLETING THE EQUIPMENT REBATE APPLICATION.