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Application for Green Town Hot Water System Rebate

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					                                                                                               Electricity Networks Corporation ABN 18 540 492 861




                          Application for Green Town Hot Water System Rebate
                          For further information visit www.westernpower.com.au/greentown
                                         or contact Western Power on 13 10 87.




Please note: all questions must be completed for us to process your application. The licensed plumber who
has installed the system is required to complete section 3 and 4.
Completed application forms with receipts are to be sent within 30 days of installation, via post to:
Smartgrid program - Hot Water System Rebate, Energy Solutions GPO Box L921 Perth WA 6842
or email a scanned copy of the application and receipts, within 30 days of installation, to
greentown@westernpower.com.au

1. Applicant details
Title (e.g. Mr, Mrs.)                              First name

Surname

Daytime telephone           (               )                                         Mobile

Email


Installation address

Address

Suburb                                                                                                        Post code


Postal address (if different to above)

Address

Suburb or town                                                                                                Post code




2. Replaced electric hot water system details
Type of replaced system                           Electric storage                  Electric instantaneous

Estimated age of replaced system                  Less than 5 years                 5-10 years                    10 years or more

Why did you replace this system?                  Broken                            Getting old                   Reduce energy usage

                                                  Reduce greenhouse gas emissions   Promotion/Rebate

Number of people in your household




Western Power office use only

Entered by                          Date             /               /                Approved                  Not eligible           RFI

Sequence number                 Supplier number                  Authorised by         Date               /               /

Notes




                                                                                               Application for Green Town hot water system rebate 1
                                                                                                        Electricity Networks Corporation ABN 18 540 492 861




3. New gas-boosted hot water system details (licensed plumber to complete)
System capacity (in litres or litres/min)

System model number:

Date of hot water system installation:

Date of hot water system purchase




4. Licensed plumber’s declaration (please print clearly)
Company name

Plumber’s name

Plumber’s licence number

Plumber’s contact number


I certify that I have done the plumbing work required to connect the hot water system in accordance with the applicable
plumbing guidelines. I certify that the information provided in this application is truthful and correct.


 Signature                                                                                       Date               /              /




5. Applicants declaration (please read carefully and confirm by ticking the following)
I declare that:


    I am the owner of the property or have sought the owner’s permission to install the new gas-boosted hot water system.

    I have read, understood and accept the terms and conditions of the rebate program.

    The information contained in the application is truthful and correct.

    I am replacing an existing electric instantaneous or electric storage hot water system.

    The new hot water system is a gas-boosted solar system.

    The property at which the new hot water system is installed is in the eligible area (see terms and conditions).

    I have attached a copy of the receipt(s) for my new gas-boosted solar hot water system, indicating: the system model number, the full price
    and that payment has been made in full.



 Signature                                                                                       Date               /              /




                                                                                                        Application for Green Town hot water system rebate 2
                                                                                    Electricity Networks Corporation ABN 18 540 492 861




Terms and conditions

The following terms and conditions apply to Western Power’s Green Town Hot Water System Rebate program.
The applicant should read them carefully before signing the application form.

Application

An application for rebate must be submitted on an official ‘Application for Green Town Hot Water System Rebate’
form and must be approved by Western Power before a rebate can be issued.

Eligibility

To be eligible for the rebate all of the following conditions must be met:
(a) Applicant
    The applicant must be the owner of the property or have sought permission from the owner of the property.
(b) Property
    The property must be located in the postcode areas 6398 or 6333, or in the locality of Bornholm, Elleker,
    Kronkup, Lowlands, Nullaki, Redmond West, Torbay, West Cape Howe or Youngs Siding.
(c) Application
    The application must be received by Western Power within 30 days of the installation of the system and prior
    to any published termination date for the rebate program.
(d) Installation
    The gas-boosted solar hot water system must have been installed and paid for in full between 4 May 2009 and
    30 April 2010.
(e) Receipts
    A copy of the receipt(s) must be attached to the application form. The receipt(s) must be in the applicant’s
    name. (Please note that invoices without proof of payment are not acceptable.)
(f)   Hot water system
      The hot water system must:
      •	 Be a new gas-boosted solar hot water system.
      •	   Replace an existing electric instantaneous or electric storage hot water system.
      •	   Meet all relevant standards and local council requirements.
      •	   Be installed by a licensed plumber.

Rebate amount

A rebate of $400 is available to eligible applicants.

Ongoing operation of hot water system

The hot water system must operate on the property for a minimum period of two (2) years after installation.

Sole rebate

Western Power will only issue one (1) Hot Water System Rebate per property.

Refund of rebate

Applicants may be required to repay the rebate if any of these terms and conditions are found to be breached in the
first two (2) years after installation of the hot water system.




                                                                                    Application for Green Town hot water system rebate 3
                                                                                    Electricity Networks Corporation ABN 18 540 492 861




Program changes

Western Power reserves the right, at its sole and absolute discretion and at any time, to change any or all of the
terms and conditions of the rebate program or to cancel the rebate program prior to 30 April 2010. The terms and
conditions are available on the Western Power Green Town website.

Liability

The applicant acknowledges and agrees that as far as the law permits, Western Power (and its successors) accepts
no liability in respect to any claim, cause of action or loss or damage arising out of, or in relation to, any hot water
system or the use of any water from such hot water system that is the subject of funding assistance.
The applicant agrees that they will indemnify and keep indemnified Western Power from any claim or liability
arising out of, or in relation to, the hot water system that is the subject of this application to the extend that any
claim or liability is not caused by Western Power’s negligence or breach of this application or any other term
implied by law.


Payment

Payment of approved rebates will be by cheque only and made payable to the applicant as identified in the
application form. The cheque will be posted to the postal address identified in the application form within thirty (30)
days of receipt of the application by Western Power.




                     For more information about the Green Town Hot Water System Rebate
                                             visit: www.westernpower.com.au/greentown
                                                                         or call 13 10 87



                                                                                     Application for Green Town hot water system rebate 4

				
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Description: Application for Green Town Hot Water System Rebate