Emmetsburg Municipal Utilities Appliance Rebate Application
* NOTE: Application must be filled out completely. * Appliance must be installed to receive the rebate. Appliances fueled by natural gas only are eligible for rebates. * Original sales receipt must accompany this application and indicate date of purchase, dealer’s name, address, and quantity purchased.
Applicant Name (Person Receiving Rebate):
Account Number (As shown on Utility bill):
Appliance Location Address (If Different):
Energy Efficiency Rating:
How would you like your rebate issued?
Applied to account #:
Account # for rebate (if selected above):
Customer Certification and Agreement
The systems(s) at the above address has been selected and installed in accordance with guidelines established for the EMU appliance rebate program. The customer understands that prior to the issuance of any payment; the equipment may be inspected by EMU. The customer shall observe and comply with all ordinances, laws and requirements of all units of government and governmental agencies having jurisdiction over the work to be performed. EMU does not guarantee that the equipment funded under this program will result in energy savings. In no event shall EMU be liable for any incidental or consequential damages.
Acknowledgement of Required Documents
I agree to send a copy of my receipt/invoice to Emmetsburg Municipal Utilities, either by email to email@example.com or by mail to: EMU, P.O. 417, Emmetsburg, IA 50536
I will upload my receipt/invoice below.
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