Get documents about "Mail -in Rebate
Document Sample
Optional Information:
Mail-in
What was the main reason you purchased a select
ENERGY STAR® Qualified Refrigerator or Freezer?
Please check one:
N energy savings N larger capacity
Rebate
N available rebate N quieter operation
N like to buy the best N concerns with global
warming/climate change
N takes up less space
N other
50
Did you know about the rebate before you purchased
$
your refrigerator or freezer?
N yes N no
If so, did the rebate influence your purchase decision?
N yes N no
Why did you purchase a refrigerator or freezer at this time?
Check all that apply:
N old machine broke N remodeling
N wanted upgrade N new home
N energy savings N better performance ENERGY STAR® Qualified
N new purchase (does not replace old unit) Refrigerators or Freezers
Have you purchased other ENERGY STAR qualified products?
N yes N no
How did you hear about ENERGY STAR Qualified
Refrigerators or Freezers? Check all that apply:
N newspaper ad N TV ad
N web site N utility bill insert
N retailer/salesperson N friend/relative/co-worker
N news report/article N other
N magazine ad
Email Address
N Yes! Sign me up to receive energy saving and incentive
information from myenergystar.com.
Congratulations on your decision to buy
an ENERGY STAR Qualified Refrigerator or
Freezer. It's good for you, your family, and
the environment. Thank you!
Valid for purchases made January 1, 2010 - December 31, 2010. All rebate requests must be postmarked no later
than January 31, 2011. Limit: One refrigerator and one freezer rebate per Massachusetts residential electric
account per calendar year. Eligible refrigerator or freezer must be installed in Massachusetts. Refrigerator must be
7.75 cu. ft. or larger to be eligible. Excludes compact models. For more information, call: 1-877-ESTAR 4 U This rebate is for the benefit of Massachusetts electric customers of:
(378-2748). This rebate offer is available to all Massachusetts residential customers of participating utilities and
energy efficiency service providers and may be subject to change without prior notice. This rebate may not be
combined with any other utility or energy efficiency service provider offer; however, it can be combined with
American Recovery and Reinvestment Act (ARRA) incentives. The participating utility or energy efficiency service
provider reserves the right to conduct field inspections to verify installations. Limitation of liability: Participating
utility or energy efficiency service provider does not guarantee the performance of installed equipment expressly or
implicitly. Customer agrees that the Energy Efficiency Program Provider (EEPP) has the unilateral right to apply for
any ISO-NE capacity payments or environmental credits resulting from this energy efficiency project, and agrees
not to file for such payments or credits either directly or indirectly. Manufacturer and/or retailer agree to provide the
EEPP with such further documentation as the EEPP may request to confirm the EEPP's ownership of such benefits.
Printed on 100%
myenergystar.com recycled paper. A-9 12-09
The ENERGY STAR® $50 Mail-in Rebate.
Get cash back from us. Get $50 back from participating utility or energy
With a new ENERGY STAR qualified refrigerator efficiency service provider on your purchase of an
or freezer, you can start saving right away. For eligible ENERGY STAR Qualified Refrigerator or
a limited time, receive a mail-in rebate of $50! Freezer. This rebate is good for purchases made
January 1, 2010 through December 31, 2010.
Some restrictions may apply. Just ask your local
participating retailer for details. To receive your rebate:
1) Fill out this form completely.
A fridge made before 1993 could be costing
2) Enclose a copy of your dated sales receipt
you approximately $300 each year to operate, and a recent copy of your electric bill.
depending on the size and model year. Replace
3) Mail it to the address below.
it with a new ENERGY STAR qualified model
Incomplete information will delay or disqualify your rebate. All
and cut your related energy costs in half. See
rebate requests must be postmarked no later than January 31, 2011.
the chart below for comparisons of sample
equipment types, including savings associated Mail to:
with ENERGY STAR qualified freezers. EFI – MA ENERGY STAR Refrigerator/Freezer Rebate
40 Washington Street, Suite 2000
Westborough, MA 01581
Typical Annual Savings from Replacing
an Old Refrigerator or Freezer with an (Please DO NOT include rebate coupon with utility bill payment.)
ENERGY STAR Qualified Model of Equal Size Please fill out completely. All information below is required.
Your Name
$300 Account/Installation Address
250 City State Zip
Home Phone
200
Annual Savings
Work Phone
150
Mailing Address (if different)
100 City State Zip
50 House type (check one in each row):
$0
Top Freezer Bottom Side-by-Side Chest
N own N rent
Refrigerator Freezer
Refrigerator
Refrigerator Freezer N primary residence N vacation home
N single family N condo/ N multifamily
townhouse ___ # of units
Appliance Type
Year of Purchase
For installation address:
N Pre-1993 Your energy efficiency provider (check one):
N 1993-2000 N NSTAR N Western Massachusetts Electric
N 2001-2008 N Unitil N Cape Light Compact N National Grid
Account #
Mfr. and Model # of ENERGY STAR Qualified Refrigerator
Only products delivering the highest level of
energy efficiency can earn the ENERGY STAR. or Freezer purchased
Look for them at participating retailers. Name and address of store where refrigerator or freezer
Call 1-877-ESTAR 4 U (378-2748) or visit
was purchased
myenergystar.com for a complete list of
participating appliance retailers.
Purchase Price $______ Purchase Date ____/____/____
