Insulation and Weatherization Rebate Form

781-246-6363

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Residential Rebates

Insulation and Weatherization Rebate Form

Qualifying energy improvements:

Insulation and Air Sealing – 50% up to $2,000.

Customer Information

12-digit WMGLD Account Number:

Account Holder Name

First

Last

Phone

Utility Account/Installation Address (please do not list P.O. Box #)

Address

Address Line 1

Address Line 2

City

State

Zip Code

Contractor Information

Contractor Name

License #

Address

Address Line 1

Address Line 2

City

State

Zip Code

Audit Date

#2 Phone Holder

Measure(s) Installed

Provide Description of Measure(s) (i.e. Air Sealing, Attic Insulation, Wall Insulation, etc.)

Customers will only be eligible to receive a rebate for specific energy improvements after the initial audit and post audit have been performed and the appropriate paperwork and receipts have been submitted. Residential customers must submit a copy of the pre and post audits, a clear copy of sales receipts and contractor bills. There will be no exceptions.

Rebate will be applied directly to customer account as a credit. Please allow one to two billing cycles for your credit to appear on you bill.

Attachment #1

Drag & Drop Files, Choose Files to Upload You can upload up to 3 files.

Attachment #2

Drag & Drop Files, Choose Files to Upload You can upload up to 3 files.

By clicking the "Submit Application" button, I certify that a licensed contractor has installed the measures listed in accordance with the state and local codes.