Weatherization Services Incentive

2. 
3. Weatherization Services Incentive
   Applicants must have completed measure installation, as recommended by our partners at Center for EcoTechnology (CET), and have a signed post installation inspection prior to submitting this rebate form. Self-installation of insulation is not eligible for rebate. Customers must be in good standing. Submissions valid from 1/1/21-12/31/21. IELD reserves the right to end these rebates at any time.
7. Account Holder Information
9. Electric Account #*
10. First Name
11. Last Name*
12. Rent or Own?*
    -- Select One --RentOwn
14. Tax ID
    Required if owner is incorporated
15. Requested Rebate *
    -- Select One --Blower Door Test & Air Sealing - 75% up to $2,000Insulation and Air Sealing - 75% up to $2,000Insulation, Air Sealing, and Installation of Air Source Heat Pump - 75%

    Select eligible measures.
16. Total Rebate Amount Requested*
18. Phone Number*
19. Email Address*
20. Service Address*
22. Mailing Address
    (if different from service address)
23. City
24. State
26. Zip
27. Receipt/Work Order*
    *Please upload all dated invoices/work orders that document the installation. Invoices and/or work orders should include the name, license number, address and phone number of the contractor that completed the installation.
28. Inspection Form*
    *Please upload the signed inspection form.
30. Rebate Payable to:*
    -- Select One --Account HolderOwner/LandlordOther

    Please indicate to whom the rebate should be made payable
31. If 'Other'
35. Owner/Landlord Information
    *Complete only if the account holder is NOT the owner or landlord of the installation location.
37. First Name
    (if different than account holder)
38. Last Name
    (if different than account holder)
42. Contractor Information
44. Contractor Name*
45. License Number *
46. Federal Tax ID #
48. Phone Number
50. Mailing Address
52. City
53. State
54. Zip
56. Measure(s) Installed*
    Please provide a description of the measure(s) installed (i.e. Blower Door Test, Air Sealing, Attic Insulation, Wall Insulation, Duct Sealing etc.)
57. Customer Acknowledgement
    By submitting this form, I hereby request a rebate for the listed work. I certify that a licensed contractor has installed the measures listed in accordance with state and local codes.
Leave This Blank:


59. 1. Receive an email copy of this form.
60. Email address

    This field is not part of the form submission.

61. Submit

* indicates a required field