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Member Rebate Application

Please fill out and submit the form below.

Name:

Address:

City:

State/Zip:

Home Phone:

Work Phone:

Email Address:

Installation Address:

Account Number:

Type of Rebate: Marathon/Energy Star rated Water Heater ($60.00)

1 Manufacturer:

Model #

Serial #:

Efficiency Rating: Date of Purchase:

Energy Star Refrigerator ($30):

2 Manufacturer:

Model #

Serial #:

Efficiency Rating: Date of Purchase:

Front Loading Energy Star Clothes Washer ($100):

3 Manufacturer:

Model #

Serial #:

Efficiency Rating: Date of Purchase:

Type of water heater:	Electric
	Gas

To qualify for the above rebates you must be a current member of Tanner Electric Cooperative. Please fill out this form in its entirety and return to Tanner with a copy of your receipt. Requests for rebates must be received within 90 days of purchase. Please allow 2-4 weeks for processing. These programs are subject to change without notice. Tanner Electric Cooperative reserves the right to inspect all installed measures prior to issuing a rebate.

By checking this box, you are verifying that you understand the qualifications and that all information you are submitting is accurate.