Exploring the intricacies of the Form 620-001 unveils a gateway to significant financial incentives for residents of New Jersey seeking to enhance their home's energy efficiency. The $900 NJNG Enhanced Rebate Application Form is more than just paperwork; it is a detailed procedure established to guide customers through upgrading their home heating systems to high-efficiency furnaces or boilers. This form encapsulates customer information, rebate recipient details, contractor or installer information, and equipment data, setting the stage for a seamless transaction. The core requirements include purchasing and installing eligible high-efficiency heating equipment after an energy audit by a BPI certified auditor, and securing this investment must occur within a precise timeline to qualify. Additionally, the form lays out comprehensive instructions for completion, alongside critical terms and conditions, illuminating NJNG's (New Jersey Natural Gas) commitment to not only fostering energy savings but also ensuring program integrity and compliance. This initiative underscores an encouraging collaboration between homeowners, contractors, and the State of New Jersey's Board of Public Utilities, emphasizing the collective effort towards a greener future. Hence, understanding and adhering to the stipulations of the Form 620-001 can lead to not only a substantial rebate but also a significant stride towards energy efficiency and sustainability in New Jersey homes.
| Question | Answer |
|---|---|
| Form Name | Form 620 001 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | SaveGreenProjec t_620 001 njng pdf savegreen rebate form |
Form#
$900 NJNG Enhanced Rebate Application Form
A. Customer Information
New Jersey Natural Gas Account Number: – – –
Account Holder First Name: _______________________ Account Holder Last Name: __________________________
Installation Address: ____________________________________________________________________________
City: ____________________________________________________ State: NJ Zip: ________________________
Daytime Phone: _____________________________ Account Holder
REQUIRED FOR REBATE: I have attach paid receipt |
REQUIRED FOR REBATE: I have had an energy audit |
I want to learn more about
I have read, understood and comply with all of the rules and regulations concerning this rebate program. I certify that all information provided is correct to the best of my knowledge, and I grant New Jersey Natural Gas Company permission to share my records with the State of New Jersey, Board of Public Utilities or its contractors, who plan to evaluate my energy usage. I hereby grant to New Jersey Natural Gas Company and its employees and agents reasonable access to my property during normal business hours to inspect the installation and performance of the furnace or boiler that is the subject of this rebate application. Further, I understand and agree to comply with all of the terms and conditions of this rebate program. Application must be postmarked within 120 days of purchase date.
Customer Signature: ____________________________________________________ Date: ____________________
B. Rebate Recipient – To be completed when rebate check is to be issued to party other than account holder.
.
First Name: _____________________________________ |
Last Name: ____________________________________ |
Company Name: ________________________________ |
(if applicable) Daytime Phone: ________________________ |
Mailing Address: ________________________________________________________________________________
City: ____________________________________________________ State: NJ Zip: ________________________
Customer Signature: ____________________________________________________ Date: ____________________
C. Contractor/ Installer – All fields must be completed by the installing contractor.
Company Name: ________________________________________________________________________________
First Name: _____________________________________ Last Name: ____________________________________
Street Address: ________________________________________________________________________________
City: ____________________________________________________ State: NJ Zip: ________________________
Phone Number:: _____________________ Fax Number: _____________________
D. Equipment Information – Contractor to assist customer in completing.
If energy audit already performed, name of participating BPI contractor (Company Name): ________________________
Gas Furnace Gas Furnace with ECM Gas Boiler AFUE of OLD EQUIPMENT:________________________
Gas Furnace with ECM connected to Central Air Conditioning
Purchase Date: _______________________ Manufacturer: ______________________________________________
Model Number: __________________________ Serial Number: __________________________________________
Heating System Information (Check one, if applicable) Conversion from Electric Propane Oil
For Office Use Only
Date Received: ______________ AFUE: __________________ Approved: _________________
Form# |
2011 New Jersey Natural Gas Company |
|
SAVEGREEN Project™ Rebate Application Instructions, Terms and Conditions |
A.CUSTOMERS- TO QUALIFY FOR YOUR REBATE, YOU MUST:
1.Purchase and install, on or after April 11, 2010, but by no later than December 31, 2011, a
2.The
3.NJNG RESERVES THE RIGHT, WITH THE APPROVAL OF THE STATE OF NEW JERSEY, BOARD OF PUBLIC UTILITIES, TO TERMINATE, MODIFY, SUSPEND OR EXTEND THIS REBATE PROGRAM. THIS REBATE PROGRAM WILL END ONCE THE FUNDING APPROVED FOR IT HAS BEEN EXHAUSTED, WHICH MEANS THAT IT MAY END PRIOR TO DECEMBER 31, 2011. IT IS THEREFORE IN YOUR INTEREST TO SUBMIT REBATE APPLICATIONS AS EARLY AS POSSIBLE.
4.All rebate application forms (including all supporting documents) must be received by NJNG on or before January 31, 2012.
5.Application must be postmarked within 120 days of purchase date.
Equipment Type |
Minimum Efficiency Level |
Rebate Amount |
|
|
|
Gas Furnace |
AFUE* 92% or greater and ENERGY STAR QUALIFIED |
$900.00 |
|
|
|
Gas Furnace with ECM* |
AFUE 92% or greater and ENERGY STAR QUALIFIED |
$900.00 |
|
|
|
Gas Boiler |
AFUE 85% or greater and ENERGY STAR QUALIFIED |
$900.00 |
ENERGY STAR qualified product lists may be found at www.energystar.gov
*AFUE (Annual Fuel Utilization Efficiency) ECM (Electronically Commutated Motor) EF (Energy Factor)
B. INSTRUCTIONS FOR COMPLETING THE REBATE FORM:As the customer, you are responsible to ensure that all requirements are met.
Sections A & B of this form |
Customer to complete |
|
|
Section C of this form |
Contractor to complete |
|
|
Section D of this form |
Contractor to assist customer in completing |
|
|
Copy of itemized sales receipt showing proof of purchase |
Customer to provide with application |
(marked PAID if proposal) |
|
|
|
C. IMPORTANT TERMS AND CONDITIONS
1.If the customer portion of the rebate is to be assigned to another party, the customer must authorize this by completing and signing section B of the application form.
2.It is the responsibility of the customer to ensure that all requirements for the rebate are met and that all required documentation is provided to NJNG.
3.Rebate payments will be based on the equipment purchase date.
4.Failure to provide any of the required information will prevent processing of NJNG’s application.
5.Please allow up to 30 days from the date NJNG receives all required information to process your rebate.
6.NJNG reserves the right to inspect all installations in order to ensure compliance with all program requirements.
7.Installations of equipment in new homes are not eligible for either participation or rebate in the NJNG SAVEGREEN Rebate program.
8.Customers who have, or will be receiving a rebate or other financial incentive for the purchase or installation of a furnace or boiler pursuant to any New Jersey’s Clean Energy Program (NJCEP) rebate or incentive program other than WARMAdvantage (i.e. Home Performance with ENERGY STAR®) are not eligible to participate in or receive a rebate from NJNG under this rebate program.
9.Program procedures, requirements and rebate levels are subject to change or cancellation without notice
10.NJNG provides no oversight or control over any contractor services related to this program. Responsibility for proper installation, as well as delivery and workmanship related to any equipment or services the customer procures rests exclusively with the contractor selected by the customer. NJNG assumes no responsibility for oversight of contractor services.
11.One rebate check will be issued to the customer applying for each approved and completed application.
12.NJNG audits its rebate programs as a protection against consumer and/or contractor fraud. Any attempt to defraud NJNG or NJCEP will result in automatic rejection of the rebate application and possible legal action
13.Installations must be completed in accordance with all laws, codes and other requirements applicable under federal, state and local authority.
14.You are urged to seek appropriate professional advice concerning any tax liabilities that could be associated with the receipt of the rebate.
15.Customers participating in any NJCEP (other than WARMAdvantage) or New Jersey Weatherization Assistance Programs are not eligible for rebate.
_________________________________________________________________________
INSTRUCTIONS FOR SUBMITTING THE SAVEGREEN REBATE
1.Keep copies of all above required documents. If contractor is submitting the rebate documents for you, we suggest you request your set of copies to be mailed to you simultaneously.
2.If you are applying for more than one rebate, separate rebate forms are to be completed for each individual unit.
3.Send signed rebate form (keep copy for yourself) along with the above mentioned documents to the address below:
SAVEGREEN PROJECT
New Jersey Natural Gas
1415 Wyckoff Road
Wall, NJ 07719