Fillable City of Banning Residential Ultra Low-Flush Toilet Rebate (City of Banning)

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City of Banning Residential Ultra Low-Flush Toilet Rebate (City of Banning)

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First Name Last Name Initial
Address City State Zip Code
Day Time Phone
Electric Account Number
Year Residence Built: Store Purchase Date
Brand of Toilet Manufacturer’s Model # Purchase Price
Brand of Toilet Manufacturer’s Model # Purchase Price
I understand and agree that the choice of improvements, the selection of contractors, the purchase
of items and acceptance of materials used and work performed, and the payments thereof, is my
responsibility. I understand that the City of Banning does not endorse, recommend or make any
representations as to specific brands, products, contractors or dealers; nor does it guarantee material or
workmanship. I also agree to allow the City of Banning to access my premises for verification purposes.
Rebates will be applied to the customer’s utility account.
City of Banning
Residential Ultra Low-Flush Toilet
Rebate Application
__________________
Date
_____________________________________
Customer Signature
_____________________________
Date
_____________________________
Authorization
for payment:___________________
Signature_____________________________________
(Public Benefits Coordinator)
Signature_____________________________________
(Public Benefits Program Manager)
Date
For office use only:
Audit Completed______________________Date___________________Cycle____________
City of Banning, Public Benefits, 176 E. Lincoln St., Banning, CA 92220 (951) 922-3260 Banningca.gov
Email Address: PublicBenefits@banningca.gov
Page 1 of 2
Email Address
Revised 4/2/2020
Page 2 of 2
City of Banning Public Benefits Program Guidelines
• Residential Ultra Low-Flush Toilet
Program Description:
The Ultra Low-Flush Toilet Rebate is a water conservation incentive program that offers
residential water customers the opportunity to replace their existing high water use toilet
fixtures with water saving Ultra Low-Flush Toilets (ULFT).
Program Guidelines:
• This program is available to the City of Banning residential water customers.
• Rebates are provided for each Ultra Low-Flush Toilet installed that uses 1.6 gallons of
water or less per flush. There is a limit of two toilets per account.
• The level incentive is $30 per qualified toilet Effective July 1, 2013. Rebate amount cannot
exceed the purchase price of the new unit.
• Qualified units must be replacing units using higher volume of water per flush.
• Following the purchase and installation of the new qualified ENERGY STAR rated
product, complete and return the application to: City of Banning, Public Benefits
Department, 176 E. Lincoln Street, Banning, CA 92220 or
Email: PublicBenefits@banningca.gov
• The application and a copy of the dated sales receipt must be submitted within 180 days
of purchasing the product in order to qualify for a rebate.
• Please provide proof of Manufacturer, Model No, and gallons per flush with the
application.
• Toilets must be installed before rebate is issued.
• Rebates will be paid to the City of Banning residential water customer of record only. The
name on the receipt must match the name on the water customer account.
• All customers participating in this program are subject to a visual on-site installation
inspection, which will be conducted within 24 months after the application has been
processed. Disparities discovered during the home audit may result in a rebate
reversal.
• Residences built or bathrooms remodeled since 1994 are not eligible for participation.
• Rebates will be given to all qualified applicants submitting proper paperwork.
• Rebates will be issued within 6 to 8 weeks after verification of submitted paperwork.
• Program will continue provided funds are available.
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City of Banning Residential Ultra Low-Flush Toilet Rebate (City of Banning)

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Completed 21 September 2021

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