Additional requirements: SEER > 15 & HSPF > 8.5 SEER > 18 & HSPF > 9.2

Promotion Dates: 06/01/2016 - 05/31/2021Requests MUST be postmarked within 180 days from the date of installation.

To receive your Duquesne Light Visa Prepaid Card by mail, follow these steps:1. Purchase and install a qualifying product where there is an active meter using Duquesne Light services.2. Review the Terms and Conditions on the bottom of this application and sign the Acceptance of Terms below.3. Mail this completed and signed application with the following supporting documents to the address on right.

A copy of your most recent Duquesne Light Utility bill. Please include all pages so your supplier agreement ID can be confirmed.

A clear legible copy of your itemized receipt/invoice that shows retailer/contractor name, address, phone number, purchase and/or install date, quantity, size, description, manufacturer, model, purchase price and proof of payment.4. IMPORTANT: Photocopy your entire submission for your records.

Subject to Watt Choices program funding availability. Prepaid cards will be mailed to customers within 60 days of the postmark date on your qualified application. To review the status of your application please go to https://frontdoor.portal.poweredbyefi.org/initiative/dlc or call 1-888-465-2070. Your right to receive this rebate will not be earned unless you purchase a qualifying appliance and follow each of the steps above. This rebate is available to Duquesne Light customers with mailing addresses in the United States. Duquesne Light is not responsible for lost, late, damaged, illegible, misdirected or postage-due applications. Your rights to this rebate cannot be assigned or transferred. Excessive submissions constitute fraud and may result in federal prosecution under the U.S. mail fraud statutes (Title 18, USC 1341 and 1342). All submitted materials become property of Duquesne Light and will not be returned. Rebate paid in the form of a prepaid card. Card is issued by The Bancorp Bank, Member FDIC, pursuant to a license from Visa U.S.A. Inc. and can be used everywhere Visa debit cards are accepted in the U.S. Pay close attention to the expiration date printed on the front of the card. Card is valid through the last day of the month. You will not have access to the funds after expiration. Card terms and conditions apply.

Manufacturer Cooling Capacity

Date Installed(MM/DD/YYYY)

*First Name *Last Name

*Address (Your prepaid Mastercard will be mailed to this address.)

*City *State *Zip Code

Email (Used to send status updates regarding this application.) Phone

*Signature *Date

Model #

ALL SECTIONS ARE REQUIRED TO BE COMPLETED IN ORDER TO QUALIFY.

Rebate Rebate Expected Qualifying Products

Central Air Conditioner SEER Rating ≥ 15: ____________ ____/_____/_______

____/_____/_______

Duquesne Light Visa® Prepaid Card HVAC Rebate Application

$100 per ton

Heat Pump (must be electric heat) SEER: _______ HSPF: _______ Heating BTUH: ________

Motor must be a brushless, fully variable speed DC motor. Excludes multi-speed motors.

$100 per ton

____________(tons)

____________(tons)

Qty

____/_____/_______$100

Programmable Thermostat (must be electric heat) ____/_____/_______ $25

____/_____/_______ $100ENERGY STAR® Certified Ductless Mini-Split Heat Pump

Check box for Contractor Payment Authorization - Account holder must fill in contractor’s information below and sign as authorization.

*Contractor First Name: ____________________________________ *Last Name or Contractor Company Name:_______________________________________________________

*Mailing Address: _________________________________________ *City:_____________________________*State:________*Zip:_____________ *Phone:___________________

*Account Holder’s Signature: ________________________________________________________________________*Date: _________________________

Furnace with High Efficiency Fan Motor (CEE) For a list of qualifying models, visit https:/https://frontdoor.portal.poweredbyefi.org/initiative/dlc

Acceptance of Terms: I have read the Terms and Conditions of this offer and I understand Duquesne Light reserves the right to audit my rebate application and if requested, I will allow Duquesne Light representatives access to verify the installation of qualifying appliance(s). I understand Duquesne Light may provide my name and address to Duquesne Light representatives to verify this information, and I approve sending the rebate to the address I have provided above.

** Complete this section ONLY if you authorize Duquesne Light to issue your rebate to your contractor. **

*Duquesne Light 10-DigitSupplier Agreement ID: (This can be found on page 3 of your utility bill)

* Denotes Required Fields

How did you hear about this rebate? Newspaper Radio Service Line Internet In Store Other:_____________________

**This question MUST be answered in order to be eligible for a rebate.Heating Type? Electric Space Heating Electric Space Heating w/AC Natural Gas/Propane/Oil Space Heating Non-Electric Space Heating w/AC

HSPF (Heating Seasonal Performance Factor)

Duquesne Light Rebates PO BOX 2528 Manchester, CT 06045