Electric Motor Rebate Form

You must receive service from Poudre Valley REA to be eligible for rebates. Rebate requests must be submitted within 90-days of purchase or installation to qualify. Rebates under $250 are applied as a bill credit. Rebates over $250 are issued to you as a check.

Typically the rebate process takes 6-8 weeks to complete.

All rebates are for new equipment only.

Applicant Information

Organization

First Name

Last Name

PVREA Account Number

Account numbers should be less than 10 digits no special characters

Phone

Address line 1

Address line 2

City

State Abbreviation

Zip Code

Equipment Information

Number of Units

Motor Manufacturer

Model Number

Application Type

Nameplate Nominal Efficiency

Motor Enclosure

Motor Type

Annual Load Factor (Percent)

Months In Service/Year

Motor Horsepower

Motor Speed

Date Installed

New or Replacement

Documentation Required: Copies of final paid installation/labor receipt or invoices. Must include ALL itemized pricing information (pre-tax costs, discounts, promotions, etc.).

Documentation Required: Additional copies of supporting documentation

Applicant Signature

By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.

Application Record Type ID

Contact Information