Renewable Energy System Cost Recovery Certification
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1
2Renewable Energy System Cost Recovery Certification
82.16 RCW
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Department of Revenue Tax Reporting No.
First, contact the utility serving your property to confirm it
is participating in this program and to receive its
(If you do not have a number, one will be assigned.)
application procedures for this incentive payment.
Instructions for Filing: Please mail or fax the following
Name, Address, Telephone No, and Email Address of
documents to the Washington State Department of Revenue
Applicant
at the address below:
Certification form
One-line diagram for the system
The Department will: (1) forward this form to the Climate &
Telephone No:
(Required)
Rural Energy Development Center at Washington State
Email Address:
University for advice on whether the renewable energy
system meets technical requirements, and (2) advise the
Location of Renewable Energy System
applicant within 30 days of receipt of this form whether the
(If different from above address)
Department approves or denies the certification.
If you have purchased property with a certified renewable
energy system, you must reapply for certification as the new
owner.
Real property and the renewable energy system are both
See page two for a list of applicable definitions. Additional
owned by applicant?
Yes
No
information about the program is available on our website at
What does the renewable energy system produce
dor.wa.gov.
electricity with?
I authorize the Department of Revenue to email my
approved certification to:
Solar inverters and solar modules manufactured
in Washington
Name of Utility:
A solar inverter manufactured in Washington
Signature:
A solar module manufactured in Washington
Qualifications:
Solar stirling converter manufactured in
Does the electricity produced meet the definition of
Washington
“customer generated electricity?”
Yes
No
Solar equipment manufactured outside of
Can the electricity be transformed or transmitted for
Washington
entry into or operation in parallel with electricity
Wind generator powered by blades
transmission and distribution systems?
Yes
No
manufactured in Washington
Permit number and date the renewable energy system
Wind generation equipment with an inverter
received its final electrical inspection from the local
manufactured in Washington
jurisdiction:
Permit No:
Date: ___________
Wind generation equipment manufactured
outside of Washington
The information provided is true, complete, and correct to the
best of my knowledge and belief under penalty of perjury.
An anaerobic digester
Signature of System Owner:
List the names of Washington manufacturer(s)
_______________________________________________
________________________________________
________________________________________
Print Name: ______________________________________
For Official Use Only Approval Signatures
Title: ____________________________________________
Department of Revenue
Mail to: Department of Revenue
Taxpayer Account Administration
_____________________________ Date _________
PO Box 47476
Climate & Rural Energy Development Center
WSU
Olympia WA 98504-7476
FAX to: (360) 586-0527
_____________________________ Date _________
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REV 41 0094e (5/14/12)
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