WMGLD Wi-Fi Smart Thermostat Form

WMGLD Customer Name (required)

12-digit WMGLD Account Number (required)

Email (required)

Phone

Street Address

City/town

Purchase Price

Purchase Date

Manufacturer
AmazonHoneywell/ResideoNest

Model #

Type of Heating Fuel at Residence:
Gas (from Municipal)ElectricHeat pumpsDuctless Mini-split

Other type of Heating Fuel:

Does Your Home have a Central Air Cooling System:
YesNo

Please attach a copy of your dated sales receipt (must show qualifying model, purchase price and paid in full) and the UPC Code from
Package
Attachment (6MB max.):

Attachment (6MB max.):

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.
By clicking "Submit Form" you agree that all information provided is accurate to the best of your ability.

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