ENERGY STAR Room Air Conditioner

Rebate Application Form

Homeowner's Name:

Purchase Date:

All documentation must be submitted within 60 days of purchase date.

Installation Address:

Cleco Meter # (starts with 168):

Can be found on your bill in the Billing Details section.

City:

City (if not listed in Drop-down)

Zip Code:

Daytime Phone # (no spaces, and include area code):

Parish:

Email Address

Mailing Address (if different from install address)

Mailing Address:

Mailing City:

Mailing Zip Code:

Mailing State:

Room Air Conditioner Details

Unit Brand

Model #

Cooling capacity of new unit (Btuh)

Reverse Cycle (choose one)

Yes
No

Louvered (choose one)

Yes
No

Room Air Conditioner Rebate Requirements

In order to qualify for this rebate, the model # must be listed on the ENERGY STAR website:

https://www.energystar.gov/productfinder/product/certified-room-air-conditioners/results

Limit 2 per customer.

Required Documentation

Proof of Purchase

Photo of Installed Unit

Signature

By submitting below, the purchase certifies that the room air conditioner(s) for which you are claiming a rebate is installed at the address listed above and authorizes Cleco to perform a phone survey or physical inspection to confirm installation. All rebate forms must be received within 60 days of purchase date of your new room air conditioner.

Program funding is limited and participation is on a first-come, first-served basis. Offerings are subject to change without notice.

Please allow 4-6 weeks for processing. For more information about this and other energy efficiency programs, visit www.cleco.com/powerwise or call 1-833-373-6842.

Signature

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