Fillable Form 3.: HIGH EFFICIENCY TOILET REBATE (City Water, Light, and Power)

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Form 3.: HIGH EFFICIENCY TOILET REBATE (City Water, Light, and Power)

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  • 5 check-boxes
  • 18 other fields

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QUESTIONS: Please call 789-2070 or email: nrgxprts@cwlp.com
1. Complete, sign and return the application within 60 days of the purchase date.
2. To qualify for a $50 rebate, the toilet must have the WaterSense® label and use no more than
1.28 gallons per flush.
3.
A copy of the sales receipt containing the purchase date, brand name, the model number, and
pre-tax purchase price must accompany the application.
4. Your rebate
will be applied as a credit to your CWLP water bill at the installation address. If
the CWLP account is more than 30-days past due, CWLP reserves the right to withhold rebate
amount until all past due amounts are paid.
5. Rebates are granted on a first-come, first-served basis until funds are depleted.
6. Limit 1 rebate per CWLP residential water account.
Name: CWLP Account No.:
Email: Day Phone:
Installation Address
(Include Zip Code)
:
Mailing Address
(If different from above)
:
Manufacturer: Model No.:
Pre-tax price: QTY purchased:
Is this toilet to replace an existing unit? YES
NO
If so, was your existing toilet pre-1992? YES NO
NO Without the rebate would you have purchased a HE WaterSense® toilet? YES
How did you hear about this rebate program? [Check all that apply]
Newspaper Friend/family Retailer Plumber Website
Other:
CUSTOMER INFORMATION
[PLEASE TYPE OR PRINT CLEARLY]:
PLEASE ANSWER THE FOLLOWING QUESTIONS:
City Water, Light & Power’s
HIGH EFFICIENCY TOILET REBATE
Use this form to request a rebate for a residential high efficient toilet install.
EQUIPMENT DETAILS
[PLEASE TYPE OR PRINT CLEARLY]:
A completed rebate form and a copy of the receipt can be returned by emailed
1
or printed and
mailed to: HE Toilet Rebate, 1008 E. Miller, Springfield, IL 62702.
1
If submiting by email attach a copy of the sales receipt to email before sending
1. This rebate is available only for units purchased and installed on property that receives CWLP metered water
service. New construction does not qualify; this program targets replacement of older less efficient toilets.
2. Should you own a condo or rental house, and the installation address is not the account to be credited, please
call the Energy Services Office for approval.
3. The CWLP account servicing the installation address [or the account to be credited if it is different] - must be
current. If the account has a past due balance of 30 days or more, the rebate will be held until the outstanding
balance is current.
4. The rebate amount is $50 and will be applied as a credit to the CWLP water bill. There is a limit of one rebate for
each water account each CWLP fiscal year [begins every March 1st]. Please allow up to 45 days for processing
this credit.
5. Rebates are granted on a first-come, first-served basis until funds are depleted each fiscal year. A completed
application does not guarantee a rebate.
6. CWLP reserves the right to verify the installation of any HE toilet prior to the rebate being processed.
Your signature is verification that you have read and agree to the Terms & Conditions on this application and affirm
that the information is correct.
Sign: Date:
CWLP HIGH EFFICIENCY TOILET REBATE TERMS AND CONDITIONS
City Water, Light & Power – Energy Services Office
1008 E. Miller Street, Springfield, IL 62702
Phone (217)789-2070 Fax: (217)789-2210
Web: www.cwlp.com/ESO
Form: 9HET2017
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Form 3.: HIGH EFFICIENCY TOILET REBATE (City Water, Light, and Power)

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Completed 22 July 2021

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