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                                                              AppliAnCe
                                                              RebAte




 Federal Tax CrediTs For energy eFFiCienCy
 Consult a qualified tax advisor or visit
 www.energystar.gov/taxcredits for
 details on any applicable federal tax credits
 or incentives available for installation of
 energy-efficient equipment.




       800-894-9599
www.MIDAMERICANENERGY.com


                                                 1175516902
Equipment application                                                                                MidAMeRiCAn eneRgy
Select equipment based on the energy ratings and                                                       AppliAnCe RebAte
terms and conditions shown on the Residential Rebate                                               Complete a separate application for each appliance purchased.
Schedule. equipment must be installed in a home
within Iowa and MidAmerican energy Company
                                                                                             q Refrigerator*............................... $50
                                                                                                  (Must be eneRgy StAR®-rated and 10 cubic feet or larger)
must supply the natural gas or electricity fueling the                                       q Freezer* ....................................... $25
appliance. only approved equipment is eligible                                                    (Must be eneRgy StAR-rated and 10 cubic feet or larger)
for energy efficiency rebates. After purchasing                                              q Dishwasher................................. $20
and installing qualifying equipment:                                                              (Must be eneRgy StAR-rated)
                                                                                             q Clothes washer (Up to $100)
1. Complete this equipment Application,
                                                                                                  MidAmerican energy dryer heat fuel ............ $50
   including signature(s).                                                                        MidAmerican energy water heat fuel ............ $50
                                                                                             (Must be eneRgy StAR-rated and have MidAmerican energy supply one of the uses below.)
2. attach a dated invoice and sales receipt from
   your dealer, including manufacturer’s name, model/                                        My dryer uses:          q natural gas q electric q Other
                                                                                             My water heater uses: q natural gas q electric q Other
   serial number and quantity of equipment purchased
   and installed. Equipment must be purchased                                                Manufacturer ___________________________________________
   and installed between Jan. 1, 2012, and                                                   Model # _______________________________________________
   Dec. 31, 2012. Rebate applications must be                                                Serial #________________________________________________
   postmarked by Jan. 31, 2013, to qualify for                                               installed cost ___________________________________________
   2012 rebate program. equipment included in                                                date installed ___________________________________________
   the energyAdvantage® new Homes program bonus                                              installer __________________________________ q Self-installed
   incentive is not eligible for additional incentives in                                    Customer Information
   the Residential equipment program.
                                                                                                                                -
3. Allow four to six weeks for processing.                                                   MidAmerican energy account number (found on bill; first seven digits only)
4. Questions? Call 800-894-9599.                                                             name on account _______________________________________
                                                                                             installation address ______________________________________
Submit applications to:
                                                                                             City ______________________________ State _____ Zip _______
  MidAmerican energy
                                                                                             Rebate payable to:
  energyAdvantage programs
                                                                                             name _________________________________________________
   .
  p O. box 4628
  des Moines, iA 50305-4628                                                                  Address ________________________________________________
                                                                                             City ______________________________ State _____ Zip _______
                                                                                             daytime phone # _______________________________________
                                                                                             evening phone # _______________________________________
                                                                                             Customer agreement
                                                                                             My signature indicates consent to and agreement with all program terms
                                                                                             and conditions. it certifies that all information in this application is correct
                                                                                             and that all of the listed new equipment has been purchased, installed and
                                                                                             is operating at the indicated location. i understand that MidAmerican energy
                                                                                             Company reserves the right to inspect and verify installation before and after
                                                                                             issuing payment.
                                                                                             _______________________________                                _______________
                                                                                             Customer signature                                             date

diSClAiMeR: MidAmerican energy Company does not guarantee that installation and                                   Please attach sales receipt.
operation of high-efficiency equipment will result in reduced usage or demand or in
                                                                                                             (Must be a MidAmerican energy customer and live in iowa.)
cost savings. the manner in which a customer uses and maintains energy-efficient
equipment affects potential cost savings. MidAmerican energy Company makes no                              Questions? Call 800-894-9599
warranties, expressed or implied, with respect to any equipment purchased and/or
installed, including (but not limited to) any warranty of merchantability or fitness for a             www.midamericanenergy.com/iowa_rebates
particular purpose. in no event shall MidAmerican energy Company be held liable for          * if the refrigerator or freezer being replaced is in working condition, you may be
any incidental or consequential damages or injuries resulting from defective equipment         eligible to participate in the Appliance Recycling program. Call 800-621-2757
or installation.                                                                               for details.

				
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