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DATE: 2009 EXISTING HOME REBATE

NAME: SSN/TAX ID:

ADDRESS:

CITY: STATE ZIP

HOME PHONE: WORK PHONE:

Acct #:

Existing Home Rebates for homes completed before January 1, 2009:

All Central Georgia EMC rebates are subject to change without notice. Rebate program will end on December 31,
2009. Prior to receiving Heat Pump Rebate, all applicants shall consent to having a Load Management Switch
installed on all applicable heat pumps and agree to have the Load Management Switch for as long as Central Georgia
EMC maintains a Load Management program. Receipts must be included with all rebate requests. Load Management
Switch installations are performed by Central Georgia EMC.

Installed Compact Fluorescent Lights (CFL) -$1.00 per light, 12 max per home Rebate $:
# of CFLs purchased Maker:
Model:

Upgrade to a Programmable Thermostat -1/2 the cost up to $25, 2 max per home Rebate $:
# purchased Maker:
Model:

Replace Gas to Electric Heat Pump Rebate-$200 for 13 SEER(R410A) or above Rebate $:
SEER Maker:
HSPF: Model:
Unit Installed by: Load Management Switch Installed

Replace Gas to Electric Marathon Water Heater Rebate-$200 for 50 gal. or above Rebate $:
WH Size Unit Installed by:

Upgrade Attic Insulation to R-39 or Greater -1/2 the cost up to $200 max Rebate $:
Job by: H/O or Contractor:
Certificate: Yes No

Total Rebate $:

I, the undersigned, Homeowner, understand the requirements set forth in each rebate program must be met in order to
qualify for rebate payment.

Signature: Date:

For CGEMC USE ONLY

Approved by CGEMC Rep:

Total Rebate $: Check # V# Date Paid:

923 S. Mulberry Street


Jackson, GA 30233
770-775-7857
White-Bookkeeping Yellow-Energy Services Pink-Customer

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