Your Request for Financial Assistance

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					Your Request for Financial Assistance

In order to obtain your remittance, you need to provide us with an application for
financial assistance that takes on the aspect of an invoice, such as the example
provided on the next page.

The invoice can only be completed once you have received approval of the final amount
of your financial assistance. This is the amount that needs to be indicated on the
application for financial assistance.

The invoice must be addressed to Gaz Métro, to the attention of the Energy Efficiency
Fund. Should the request for assistance includes several buildings or account numbers,
do indicate the specific account number or account numbers for each building.

If several account numbers are subscribed at a same program, please indicate those
numbers on the same invoice and make sure you write the final amounts of your
financial assistance for each one.

If you have QST and GST numbers, you may add the sales taxes. The taxes are
applicable on the amount of financial assistance.


For further information, we invite you to contact us.




                                             Energy Effiency Fund
              1717, du Havre Street, Montreal (Quebec) H2K 2X3    info@fee.qc.ca www.fee.qc.ca
          Montreal : (514) 529-2216    Elsewhere in Quebec: 1 866 529 8207       Fax : (514) 719-8207
To invoice :
                                                              Date:
Gaz Métro (Energy Efficiency Fund)
1717, du Havre street,
                                                              Invoice n°:
Montreal (Quebec)
H2K 2X3



Enterprise                                    Website


Name                                          Email address


Street


City


Postal Code


Phone:                  Fax:

  DESCRIPTION                                                    AMOUNT


  Program



  Address of the building :
  Gaz Métro account number :


  Address of the building :
  Gaz Métro account number :


 Address of the building :
 Gaz Métro account number :

  Subtotal :


  QST Number:                        RT0001

  GST Number:


  TOTAL :




Signature




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