Get documents about "hpwh grant claim form dec 2010
Shared by: 4A85cp
-
Stats
- views:
- 2
- posted:
- 3/6/2012
- language:
- English
- pages:
- 2
Document Sample
EECA Heat Pump Water Heating Grants Scheme
Scheme Partner Grant Claim Form
Instructions for using this form:
1. Scheme Partner should complete the yellow cells from the information provided on the Install Declaration Form.
2. Some cells are restricted - you must select one of the available options
4. On completion of this form please sign and the form on the "Declaration PLEASE SIGN" tab of this spreadsheet
5. Please send an electronic version of this file and a scan of the signed declaration sheet along with Install Declaration Forms to heatpumpwaterheating@eeca.govt.nz
Count Scheme Partner Homeowner Homeowner Flat Street# Street StreetType Suburb City Region Building Building Consent Authority Purchase Installer Name Business Name Email PDG Phone EECA System Date of Existing New System System Type Property Connection Size of
First Name Last Name Consent Consent Date Address Registr Number System Serial Installation System Pressure ports tank (l)
Required # ation ID Number Pressure
Y/N Number Number
1
1
1
1
1
1
1
1
1
1
Please do not delete below this line - Please do not delete below this line - Please do not delete below this line
10
Northland Yes Ashburton District Council Mains/ Medium Mains Packaged New build Dedicated
Auckland No Auckland City Council Low Low Custom Existing house Shared
Waikato Auckland Regional Council n/a Retrofit custom n/a
Bay of Plenty Buller District Council
Gisbourne Carterton District Council
Hawkes Bay Central Hawke's Bay District Council
Taranaki Central Otago District Council
Wanganui Chatham Islands Council
Manawatu Christchurch City Council
Wairarapa Clutha District Council
Wellington Dunedin City Council
Nelson and Bays Environment Bay of Plenty
Marlborough Environment Canterbury
West Coast Environment Southland
Canterbury Environment Waikato
Timaru & Oamaru Far North District Council
Otago Franklin District Council
Southland Gisborne District Council
Unsure Gore District Council
Greater Wellington Regional Council
Grey District Council
Hamilton City Council
Hastings District Council
Hauraki District Council
Hawke's Bay Regional Council
Horizons Regional Council
Horowhenua District Council
Hurunui District Council
Hutt City Council
Invercargill City Council
Kaikoura District Council
Kaipara District Council
Kapiti Coast District Council
Kawerau District Council
Mackenzie District Council
Manawatu District Council
Manukau City Council
Marlborough District Council
Masterton District Council
Matamata-Piako District Council
Napier City Council
Nelson City Council
New Plymouth District Council
North Shore City Council
Northland Regional Council
Opotiki District Council
Otago Regional Council
Otorohanga District Council
Palmerston North City Council
Papakura District Council
Porirua City Council
Queenstown Lakes District Council
Rangitikei District Council
Rodney District Council
Rotorua District Council
Ruapehu District Council
Selwyn District Council
South Taranaki District Council
South Waikato District Council
South Wairarapa District Council
Southland District Council
Stratford District Council
Taranaki Regional Council
Tararua District Council
Tasman District Council
Taupo District Council
Tauranga City Council
Thames-Coromandel District Council
Timaru District Council
Upper Hutt City Council
Waikato District Council
Waimakariri District Council
Waimate District Council
Waipa District Council
Wairoa District Council
Waitakere City Council
Waitaki District Council
Waitomo District Council
Wanganui District Council
Wellington City Council
West Coast Regional Council
Western Bay of Plenty District Council
Westland District Council
Whakatane District Council
Whangarei District Council
EECA Heat Pump Water Heating Grants Scheme
Grant Claim Form
Scheme Partner
Date of claim
Total allocation
Claims made to date
Claims in this report
Balance of allocation 0
Declaration
This Grant Claim Form is supported by the EECA HPWH spreadsheet attached, and Install Declaration Forms for
each claim.
I declare that the information provided in this report is correct and complete to the best of our knowledge.
EECA reserves the right to audit documentation held by the Scheme Partner to verify the eligibility of each
claim.
All personal information in this report will be held by EECA, PO Box 388, Wellington 6140. Under the Privacy Act
1993, all individuals have the right of access to, and correction of, their personal information held by EECA.
EECA will only use personal information collected for purposes related to the Heat Pump Water Heating Scheme.
Failure to provide all requested information may result in this claim being declined.
Name
Signature
Related docs
Other docs by 4A85cp
All it takes is a few breeding pairs of something to come into the system and it s
Views: 0 | Downloads: 0
