Appliance Rebate Form - …

1 PECO Energy Company 2018 | PAGE 1 Customer Information (where qualified equipment is installed) Account number (10 digits) Name on account Address (where qualified equipment was installed) City, State, Zip Daytime Phone Email (optional) I want to receive promotional material and information regarding PECO home Rebates programs How did you hear about PECO home Rebates? Contractor PECO Website Radio Bill insert/newsletter Retailer Word of mouth TV Letter to my home Social Media Other Website Email Property Type: Single Family MultifamilyIs payee different from name on account?

2 Yes NoIf yes, provide alternate payee information below: Payee is: Homeowner Landlord TenantPayee Name Payee address City, State, ZipCustomer eligibility 9 Currently receive residential electric service from PECO 9 PECO customers who have chosen an alternative electric energy supplier can qualify for PECO home Rebate FormInstructions 9 Rebate form must be received within 90 days of purchase. 9 Complete one Rebate form for each service address and for multiple products at one location 9 Allow 4-6 weeks for processing of completed Rebate forms. For faster processing submit online. 9 All qualifying products can be found at 9 Attach a photocopy (or scanned copy) of your paid receipt 9 Review the Eligibility, Terms & Conditions and Note section, then sign the completed form.

3 Rev. 1/1/18 PECO Energy Company 2018 | PAGE 2 Product InformationProduct rebateManufacturerModelQuantityENERGY STAR Refrigerator $20 ENERGY STAR Freezer $20 ENERGY STAR Clothes Washer $25 ENERGY STAR Electric Clothes Dryer $15 Heat Pump Clothes Dryer $75 ENERGY STAR Room A/C $15 ENERGY STAR Air Purifier $50 ENERGY STAR Bathroom Ventilation Fan $25 ENERGY STAR Dehumidifier $50 Product eligibility 9 New construction is not eligible 9 Qualifying product must be new 9 Product must be installed in your residenceRetailer Information Name Address Phone Purchase date PECO Energy Company 2018 | PAGE 3 Signature requiredI.

4 Certify that I am the PECO customer, or I am authorized by the PECO customer to submit this application, and that the information and dated, paid receipt provided are true and correct, that the product was installed in the service address provided above, and that product meets the requirements of this Rebate program. I further certify that the customer has read and understands the terms and conditions and eligibility of this Rebate DateTerms & Conditions The program term is January 1, 2018 through December 31, 2018. Documentation must include the completed, signed Rebate form and a dated, paid receipt that lists the retailer name, address, phone number, product name, complete model number, installation date and efficiency information.

5 Customers are responsible for any taxes associated with the receipt of a Rebate . PECO is not responsible for items lost or damaged in the mail. If your Rebate form is selected for verification, customer agrees to allow PECO or its agent access to the installation site to verify the qualified product. Failure to provide access may result in denial of the Rebate request, or refund of Rebate if already paid. Selection of qualified product, manufacturer, dealer, supplier and/or installer and purchase, installation and ownership/maintenance of the qualifying product referenced in the Rebate form are the responsibility of the customer.

6 PECO does not endorse any specific manufacturer, dealer or contractor and makes no representations regarding specific manufacturer, dealer or contractor or their workmanship. PECO makes no warranty for the use of the qualified product, and customer agrees that PECO has no liability concerning the quality, safety and/or installation of the qualified product, estimated energy savings of the qualified product, workmanship of any third parties or use of any qualified product. Customer is responsible for meeting program requirements and complying with all government, property owners, homeowner s association, or other requirements regarding restrictions, codes,ordinances, rules and regulations concerning the qualified product installation.

7 Funds are limited and subject to availability. Rebate amounts and this Rebate program are subject to change, including termination, without prior notice. If you checked the box (on page 1), you have given us permission to send you promotional material and information regarding PECO home Rebates programs. You may unsubscribe from these communications at any time by following the unsubscribe link in the email. By participating in this Rebate program, the Customer applicant agrees to abide by and be bound by these Terms and Conditions, and acknowledges that the decisions of PECO are final in all respects. Rebate amounts apply only to products purchased and installed after June 1, this form if you have purchased and installed qualified products in your residence and are the: Owner of your residence and PECO Residential Electric account holder Or Tenant and PECO Residential Electric account holder forservice to your rental unit Or Condominium Owner and PECO account holder for residential electric service to your unit Or, if you are a residential landlord whose tenants units are individually metered, please provide the PECO account number where the Appliance /equipment is installed.

8 Do not use the PECO account number for the building s common area lighting. If you do not know your tenant s PECO account number please leave it blank. Provide the tenant s name, address, and unit number in the installation address information to ApplyThere are 4 ways to apply for your online at a scanned copy or photo of a completed signed Rebate form and receipt to: completed and signed Rebate form and receipt to: PECO home Rebates 3100 West Road, Building 3 - Suite 200 East Lansing, MI 48823 the printed form to: 1-866-897-7017 Keep a copy of your Rebate form, Terms and Conditions and receipt for your records. For support, please contact PECO home Rebates at 888-259-9125.