Follow the steps to complete the form accurately.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin with the account information section. Enter your account number and premise number as indicated. If you're unsure where to find this information, refer to your energy bill.
3. Fill in your name in the customer name field, along with your phone number and service address, including street address, city, state, and zip code. If the mailing address is the same, mark the 'SAME' box.
4. In the installation section, provide the contractor or dealer name if applicable, along with their phone number and mailing address. You must also include the contractor's license number if the appliance was purchased through them.
5. Attach copies of sales invoices or receipts for the purchase and installation of the appliances. Note that allowances will only be paid on new appliances and must be requested within one year of the purchase date.
6. Complete the new appliance information section. For each appliance installed, list the type, manufacturer, model number, quantity, and allowance amount. If applicable, note the tons or kilowatts replaced.
7. If you are replacing any appliances, fill out the previous appliance information section, providing details of the old appliance along with its manufacturer and model number.
8. Review all information for completeness, ensuring no sections are left blank, as incomplete forms will be returned.
9. Certify your installation by signing the form and dating it. This indicates that you understand the terms for receiving the allowance.
10. Finally, save your changes, then download, print, or share the form as needed.

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