VIEWS: 8 PAGES: 2 POSTED ON: 6/11/2010
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 ____/____/____
" Mail -in Rebate"