50 REBATE - takechargewv.com

1 $50 REBATEOn ENERGY STAR CertifiedREFRIGERATORSFor purchases made1/1/18 12/31 information (Check all that apply):q Own q Primary residence q Rent q Second homeq Single family q Condoq Multi-family _____ # of unitsWhat was the main reason you purchased an ENERGY STAR certified refrigerator? (Please check only one).q Energy savings q REBATE q Like to buy the bestq Old refrigerator broke Other: _____Did you know about the REBATE before you purchased your refrigerator?q Ye s q NoIf so, did the REBATE influence your decision to purchase an ENERGY STAR certified refrigerator?q Ye s q NoHow did you hear about the REBATE on ENERGY STAR certified refrigerators?

2 (Check all that apply.)OPTIONAL DATA: Store newspaper adq Store websiteq Store salesperson q Print adq In-store signage q News story/articleq Utility bill messageq Radio ad q This REBATE formq Appalachian Power websiteq Appalachian Power booth at local eventq Appalachian Power representativeq Television adq Other: _____q BillboardCOMMENTS: _____Get $50 back from Appalachian Power on your purchase of a current ENERGY STAR certified refrigerator. This REBATE is good for purchases made 1/1/18 through 12/31/18. Limit one REBATE per residential electric customer account. Funding for this program is limited. Appalachian Power $50 Rebateq You are an Appalachian Power residential Your residential Appalachian Power account is for an address in the state of West You purchased* a current ENERGY STAR certified refrigerator between 1/1/18 12/31/18.

3 *All qualifying models must be purchased at a participating You have not submitted another Appalachian Power refrigerator REBATE in Application must be submitted within 45 days from purchase date or by January 31, 2019, whichever comes Refrigerator must be > cubic Complete REBATE form to the right or online at Copy of recent* Appalachian Power residential electric bill * Electric bill must be from within two months of REBATE Copy of dated sales receipt or invoice from a participating retailer showing manufacturer, model number and priceFor more information, call YOU MEET THESE REBATE REQUIREMENTS? REBATE CHECKLISTC omplete REBATE form to the right or online at Power account number: _____Name: _____Email: _____Account/Installation address: _____City: _____ State: _____ ZIP: _____Phone: _____Mailing address (if different):_____Manufacturer and model #:_____Name and address of store where refrigerator was purchased:_____Attach a copy of your sales receipt and your recent* Appalachian Power electric price: _____ Purchase date: _____Mail to.

4 Appalachian Power Refrigerator Rebate3100 West RdBldg 3, Ste 200 East Lansing, MI 48823 Required Data* Electric bill must be from within two months of REBATE $Please include a copy of your dated sales receipt and/or invoice from a participating retailer showing the manufacturer, model number and price of the ENERGY STAR certified refrigerator purchased and a copy of your recent electric bill. Incomplete information will delay or disqualify your REBATE . All REBATE requests must be postmarked no later than January 15, 2019. Please allow up to six weeks for REBATE processing. Some limitations may apply. For more information, call 888-261-4567 or email You Know?

5 Refrigerators that have earned the ENERGY STAR are about 9 percent more energy efficient than models that meet the minimum federal energy efficiency properly recycling your old refrigerator and replacing it with a new ENERGY STAR certified refrigerator, you can save more than $270 over the next five years!Refrigerators over ten years old could be costing you about $110 per year to run. If you need a second refrigerator year round, replace the old one with a new ENERGY STAR certified unit and save more than $50 a year in operating costs.