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					  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 ____/____/____

				
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posted:6/11/2010
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