Fec Energy Efficiency Rebate & Grant Forms
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1FEC ENERGY EFFICIENCY REBATE & GRANT FORMS
MEMBER INFORMATION
Name
FEC Account Number
Address
City, State
Zip
REBATE FORM
EQUIPMENT
(Please review rebate specifications and conditions.)
Description
Rebate
Qty.
Total
$
$
$
$
$
$
TOTAL REBATE
Attach copy of invoice(s). A check for your rebate total will be mailed to the address above.
CONSERVATION GRANT APPLICATION FORM
ENERGY-SAVING DEVICE (
Note: FEC will reimburse 50% of the total cost, up to $100.)
Total cost
Grant total
Description -- including make, model and size (when applicable). Please review conditions.
of item
(not to exceed $100)
X 50%
Attach copy of invoice(s). REC will review your application for a conservation grant. If approved, a check will be mailed
to the address above.
Return completed form to via e-mail to , or mail to:
Farmers Electric Cooperative, 1959 Yoder Ave. SW, Kalona, IA 52247
Office use
Reviewed
Amt.
$
Date
by
approved
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