Canby: Residential Clothes Washer and Dryer Rebate Application

Residence Type*

Site Built Home (4 units or less)

Manufactured Home

Multifamily Home (5 units or more)

Multifamily Type*

Low Rise (5 units or more, 3 stories or less)

Mid/High Rise (6 units or more, 4 stories or more)

Are the Clothes Washer and/or Clothes Dryer located in a common area of the Multifamily home?*

Yes

No

For Multifamily homes, new Clothes Washers and Clothes Dryers must be located in a common area to qualify for the rebate. Thank you for your interest.

Which rebate(s) are you applying for?*

Clothes Washer

Clothes Dryer

Select one or both. If you bought a combination model (all-in-one), check both.

Water Heater Type*

Electric

Gas

Other

Your Water Heater must be Electric to qualify for the Clothes Washer rebate.

Is the new Clothes Washer ENERGY STAR® Certified?*

Please refer to energystar.gov to learn more about ENERGY STAR® products.

Yes

No

Your new Clothes Washer must be ENERGY STAR® Certified to qualify for the rebate.

Old Dryer Type*

Electric

Gas

New Dryer Type*

Electric

Gas

Your new dryer must be electric to qualify for the Clothes Dryer rebate.

Is the new Clothes Dryer ENERGY STAR® Certified?*

Please refer to energystar.gov to learn more about ENERGY STAR® products.

Yes

No

Your new Clothes Dryer must be ENERGY STAR® Certified to qualify for the dryer rebate.

NEW WASHER INFORMATION

Clothes Washer Brand*

Clothes Washer Model Number*

Quantity*

NEW DRYER INFORMATION

Clothes Dryer Brand*

Clothes Dryer Model Number*

Quantity*

UPLOAD YOUR REBATE DOCUMENTS

Required:

Receipt(s) or invoice(s) must include brand, model number, price, and date of purchase.
Online orders must show customer name and address for shipping/delivery.

Optional:

Copy of Energy Guide label for washer showing ENERGY STAR® logo.

Drop files here or

Max. file size: 20 MB.

APPLICANT INFORMATION

Utility Account Number

Name*

First Last

Are you the utility account holder?*

Yes

No

Your relationship to utility account*

Family Member

Landlord

Tenant

Other

Phone*

Email*

Enter Email Confirm Email

Installation Address*

Street Address City State ZIP Code

Do you have a different mailing address?*

My mailing address is the same as above

I have a different mailing address

Mailing Address*

Street Address City State ZIP Code

Application Notes

Please insert any notes that you would like us to review with your application. (This is not required to submit the application.)

SUBMIT YOUR APPLICATION

By submitting this form, the applicant acknowledges that they have read and agree to the utility's Terms & Conditions found at the bottom of this page.

I agree*

I agree to the Terms & Conditions

Clothes Washers:

Clothes Dryers:

NEW WASHER INFORMATION

NEW DRYER INFORMATION

UPLOAD YOUR REBATE DOCUMENTS

Required:

Optional:

APPLICANT INFORMATION

SUBMIT YOUR APPLICATION