Smart Thermostat Rebate Application
Applicant Information
First Name
Last Name
Installation Address
City
State/Province
ZIP/Postal Code
Phone Number
Email
Smart Thermostat Information
Brand
Model Number
Serial Number
Purchase Date
Installer Name
Proof of Purchase (e.g., Receipt Number)
Household Information
Type of Home
Single-Family
Townhouse
Condo/Apartment
Other
Primary Heating System
Gas Furnace
Electric Furnace
Boiler
Heat Pump
Other
Additional Comments