* 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.

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.