Residential Window and Energy Star Qualified Insulated Door Rebate Application Asterisks (*) indicate required fields.CUSTOMER INFORMATIONAccount Number* Name* First Last Are you the account holder?* Yes No Relationship to Customer (if not account holder)* Family Member Landlord Tenant Phone*Email* Enter Email Confirm Email Installation Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific 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* Mailing Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code HOME INFORMATIONResidence Type*New construction windows do not qualify for rebate(s). Site Built Home (4-plex or less) Multi-Family Home (5-plex or more) Manufactured Home Multi-Family Type* Low Rise (5 units or more, 3 stories or lower) Mid/High Rise (6 units or more, 4 stories or higher) Please note that Mid/High Rise Multi-Family units do not qualify for the rebate on Insulated Doors.Electric Heat Source*Residence must have a permanently installed electric heat system capable of heating the entire dwelling to qualify. Wall Unit Baseboard Ceiling Cable Forced Air Electric Heat Pump Ductless Heat Pump Other Other Heat Source:* ENERGY EFFICIENT UPGRADESUpgrade? Replacement Windows ENERGY STAR Qualified Insulated Exterior Door(s) Replacement WindowsRebate(s) are for replacement windows only. Windows not inside the electrically heated area of the home, such as garages or workshops, are not eligible for rebate(s). Replacement window U-factor must be 0.30 or lower to qualify for rebates.Existing Windows*Existing windows must be single pane, single pane with storms, or double pane with metal frames to qualify. Existing vinyl and double pane wood frame windows do not qualify for rebate(s). Please select all that apply: Single Pane Double Pane Storm Metal Wood Vinyl When will your new windows be installed?* MM slash DD slash YYYY Area (sq ft)*Please enter the total square footage of all windows being replacedU-Factor*Please input any additional U-Factors into the Notes section at the bottom of this form.ENERGY STAR Qualified Insulated Exterior Door(s)ENERGY STAR® qualified door must be pre-hung, include replacement of the threshold and replace an uninsulated exterior door. Exterior doors must separate heated and un-heated space. Quantity*REBATE PROGRAM GUIDELINESPlease click the button below to find current rebate amounts. This will open a new tab. Rebate Amounts All requests for rebate funds must be pre-approved. If the work is not completed within six (6) months of approval, customer must reapply for rebate(s). There is no guarantee that funds will be available after the six-month approval or that the incentive amount will remain the same. Rebate(s) are available on a first come, first served basis and are subject to availability of funds. Before Installation: An audit and prior approval are required. Call 1-888-883-9879 to schedule. All energy efficient upgrades must be installed according to Vera Water and Power specifications. After Installation: A final inspection is required before the rebate can be processed. Please call 1-888-883-9879 to schedule after the work has been completed and all required documents have been submitted. UPLOAD YOUR FINAL DOCUMENTSThe following documents are required before final inspection of the new windows/doors: Copy of one NFRC sticker for each window replaced or the manufacturer's order confirmation with U-factor verification. Copy of one NFRC sticker for each exterior door replaced or verification that the door is ENERGY STAR® rated. Contractor installed: Copies of contractor final invoice(s) showing window measurements. All final invoices/receipts and installation must be dated on or after October 1, 2019 to qualify for the current rebate amount. Self-installed: Copies of purchase receipt(s) showing window measurements. All final invoices/receipts and installation must be dated on or after October 1, 2019 to qualify for the current rebate amount. Completed Residential Window and Insulated Door Rebate Applications form (this application form). * Drop files here or Select files Max. file size: 20 MB. Please note: We now require all documentation to be turned in before we will perform the final inspection. Please double check that you have attached all required final documents. Application NotesPlease insert any notes that you would like us to review with your application.SUBMIT YOUR APPLICATIONTerms and conditions*By clicking "submit," the applicant acknowledges the following: Rebate offer(s) may be changed or discontinued at any time by Vera Water & Power (VERA). VERA disclaims any warranty, whether expressed or implied, regarding the measure(s) listed on this application for any materials or labor associated with installation, maintenance, repair, or any energy savings associated with use. I understand that the measure(s) must be installed to VERA specifications, and certify that I, or my contractor, have reviewed the specifications prior to beginning work. When selecting a contractor, I understand that it is the homeowner’s responsibility to request proof of insurance and licensing that meets the statutes and rules of the Washington Construction Contractors Board. VERA strongly recommends validating qualifications before work begins. I understand the above and certify that I am a customer of VERA, that the measure(s) are installed at the residential address indicated on this application and that this address is within VERA service territory. I agree* Allow 8 to 10 weeks after final inspection approval and receipt of all required documentation for rebate checks to be issued and mailed. Call 888-883-9879 to learn about additional energy efficiency programs.