shrewsbury 2021 yard equipment form

By signing this form, I cer�fy that: I purchased the device(s) noted above for use at the address above; I am an electric customer of the u�lity listed above; and that to the best of my knowledge, the informa�on provided is correct and accurate. I am providing the requested informa�on solely to be eligible to par�cipate in this program and request that the personal informa�on supplied by me be treated as conﬁden�al to the maximum extent possible. CUSTOMER SIGNATURE (required): MANUFACTURER REBATE MODEL # Rechargeable Ba�ery Operated Snow Blower* $100 Rechargeable Ba�ery Operated Lawn Mower $100 Rechargeable Ba�ery Hedge Trimmer $40 Rechargeable Ba�ery Pressure Washer $40 Rechargeable Ba�ery Roto�ller $40 Rechargeable Ba�ery Chain or Pole Saw $40 Rechargeable Ba�ery Leaf Blower $25 Rechargeable Ba�ery String Trimmer $25 Customer Name SELCO Electric Account # Address City State ZIP Email Address (Op�onal) Home Phone # Cell Phone # Store/Website Name Store/Web Address HAVE ANY QUESTIONS, PLEASE CALL (413) 308-1311 OR EMAIL [email protected] CUSTOMER INFORMATION (ALL FIELDS REQUIRED UNLESS OTHERWISE STATED) • Only NEW yard equipment is eligible for rebate; refurbished or used not eligible • Device must be cordless, with a rechargeable ba�ery • Maximum of 1 rebate of each of the devices listed every 3 years • Maximum rebate is 50% of the purchase price of each item • SELCO reserves the right to end these rebates at any �me • Do not mail this rebate form with u�lity payment • Must be purchased between 6/1/2021 - 12/31/2021 & postmarked by 1/31/2022 • If mul�ple tools were purchased in a bundle, use 1 form per bundle; Please check all tools in Bundle. 1. A copy of your dated sales receipt (must include Manufacturer, Model #, and Purchase Price) 2. A copy of your recent electric bill 3. This completed form to SELCO Electric Yard Equipment Rebates c/o MMWEC 327 Moody Street Ludlow, MA 01056 HOW TO OBTAIN YOUR REBATE REBATE INFORMATION: PLEASE ALLOW 6-8 WEEKS FOR PROCESSING FORM ALSO AVAILABLE ONLINE AT SELCO.SHREWSBURYMA.GOV/LAWN MAIL IN: STEPS REQUIRED FOR PROCESSING PLEASE SELECT QUALIFYING PRODUCTS (1 PURCHASE PER APPLICATION) RECHARGEABLE YARD EQUIPMENT REBATE FORM HELPS HOME ENERGY LOSS PREVENTION SERVICES *Approved snow blower models are listed on SELCO.SHREWSBURYMA.GOV/LAWN

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Page 1: Shrewsbury 2021 Yard Equipment Form

CUSTOMER SIGNATURE (required):

MANUFACTURERREBATE MODEL #

Rechargeable Ba�ery Operated Snow Blower* $100

Rechargeable Ba�ery Operated Lawn Mower $100

Rechargeable Ba�ery Hedge Trimmer $40

Rechargeable Ba�ery Pressure Washer $40

Rechargeable Ba�ery Roto�ller $40

Rechargeable Ba�ery Chain or Pole Saw $40

Rechargeable Ba�ery Leaf Blower $25

Rechargeable Ba�ery String Trimmer $25

Customer Name SELCO Electric Account #

Address City State ZIP

Email Address (Op�onal)

Home Phone # Cell Phone #

Store/Website Name Store/Web Address

HAVE ANY QUESTIONS, PLEASE CALL (413) 308-1311 OR EMAIL [email protected]

CUSTOMER INFORMATION (ALL FIELDS REQUIRED UNLESS OTHERWISE STATED)

• Only NEW yard equipment is eligible for rebate; refurbished or used not eligible• Device must be cordless, with a rechargeable ba�ery• Maximum of 1 rebate of each of the devices listed every 3 years• Maximum rebate is 50% of the purchase price of each item• SELCO reserves the right to end these rebates at any �me• Do not mail this rebate form with u�lity payment• Must be purchased between 6/1/2021 - 12/31/2021 & postmarked by 1/31/2022• If mul�ple tools were purchased in a bundle, use 1 form per bundle; Please check all tools in Bundle.

1. A copy of your dated sales receipt (must include Manufacturer, Model #, and Purchase Price)

2. A copy of your recent electric bill3. This completed form to SELCO Electric Yard Equipment Rebatesc/o MMWEC327 Moody StreetLudlow, MA 01056

HOW TO OBTAIN YOUR REBATE REBATE INFORMATION:

PLEASE ALLOW 6-8 WEEKS FOR PROCESSINGFORM ALSO AVAILABLE ONLINE AT SELCO.SHREWSBURYMA.GOV/LAWN

MAIL IN:

STEPS REQUIRED FOR PROCESSING

PLEASE SELECT QUALIFYING PRODUCTS(1 PURCHASE PER APPLICATION)

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