Residential Appliance Replacement Impact
Household Information
Household Name
Address
Number of Residents
Appliance Replaced
Type of Appliance
Old Appliance Details
New Appliance Details
Date of Replacement
Impact Assessment
Estimated Annual Energy Savings (kWh)
Estimated Annual Cost Savings
Other Benefits
Notes
Summary
Appliance
Old
New
Energy Savings (kWh/yr)
Cost Savings