ENERGY STAR ® APPLIANCE REBATE

2024 RESIDENTIAL REBATE APPLICATION

MEMBER INFORMATION

Name *

Account # *

Address *

City *

State *

Zip *

Phone Number *

Type of Phone *

Member Type *

Homeowner

Renter

By signing this application, I certify the appliances for which I am claiming a rebate are qualifying ENERGY STAR® rated products and are installed at the address listed above which represents a valid Todd-Wadena Electric Cooperative account.

Member Signature *

clear

Date * +

EQUIPMENT INFORMATION

Energy Star ® Appliance

Clothes Dryer ($25 Rebate)

Dehumidifier ($25 Rebate)

Clothes Dryer Manufacturer *

Clothes Dryer Model Number *

Dehumidifier Manufacturer *

Dehumidifier Model Number *

Replacement with Recycling

Freezer with recycling of existing unit ($50 Rebate)

Refrigerator with recycling of existing unit ($50 Rebate)

Freezer Manufacturer *

Freezer Model Number *

Refrigerator Manufacturer *

Refrigerator Model Number *

RETAILER INFORMATION

Retailer/Store Name *

Location *

Rebates are available for the purchase of new ENERGY STAR® rated appliances purchased between January 1, 2024 - December 31, 2024. A new refrigerator or freezer purchase must include recycling of the older refrigerator or freezer. Rebate submittal must follow the guidelines as outlined by the cooperative. The cooperative is not responsible for inaccurate information supplied by appliance dealers. Rebates will be issued only for the products on the current list of ENERGY STAR® rated products as of the purchase date. ENERGY STAR® occasionally removes products from qualifying lists, and the cooperative will not rebate products that have been delisted as of the purchase date or are mislabeled as ENERGY STAR®. To verify ENERGY STAR® certification for appliances and lighting, visit www.energystar.gov. Rebate program is subject to change or cancellation without notice. Call the cooperative to verify rebate program status and availability of rebates.

IMPORTANT

•The appliance(s) must be installed within Todd-Wadena Electric Cooperative’s service territory.

•Incomplete forms will not be processed.

•Include a copy of the original dated sales receipt and a dated receipt from the recycler for replacement refrigerator and/or freezer.

•Rebate program is subject to change or cancel without notice.

•Submit completed rebate form and a copy of the original sales receipt within 90 days of purchase.

•Rebate credits under $100 will be applied to the member's account.

Upload a copy of the original sales receipt(s) and/or dated receipt from the recycler for replacement refrigerator and/or freezer (if applicable). *

This institution is an equal opportunity provider and employer.