HomeMy WebLinkAboutToilet Rebate Application 07.19.2012.pdf
City of Auburn
WaterSense® Toilet
Rebate Program
The City of Auburn WaterSense® Toilet Rebate Program provides customers up to a $100 rebate per toilet for
the replacement of up to two old toilets with new high-efficiency toilets with the WaterSense® label.
Instructions and Requirements
1. The toilet you purchase must bear the WaterSense® label.
2. You must be a current Auburn Water Customer.
3. The rebate application must be submitted within 90 days of toilet purchase.
4. The toilet(s) must be installed at a site with an Auburn Water account, not including irrigation accounts.
5. Old toilets should be recycled or disposed. They may not be resold or reused.
6. Include a copy of your water bill with your application.
7. Include a copy of your receipt showing the price of the toilet, not a product order form or estimate. If the
receipt does not indicate the specific model of the toilet, provide other documentation, such as the
WaterSense® label and model number from the packaging or installation instructions.
8. Include a completed Department of Treasury Internal Revenue Service Form W-9
9. Complete one application form for up to two rebates and return it and attachments by mail to:
City of Auburn, Water Quality Programs Coordinator, 25 West Main, Auburn, WA 98001
10. The rebate amount is the pre-tax purchase price of each toilet or $100, whichever is lower, for a maximum
of $200. The rebate covers the cost of the toilet only. Additional parts required for installation, labor
charges or tax are not eligible for rebate.
11. Incomplete applications or applications lacking requested documentation will not be processed.
12. Auburn reserves the right to inspect properties to confirm installation before rebates are issued.
13. This program is dependent on funding and may terminate without prior notice.
14. Please allow 4 – 6 weeks to receive your rebate check.
Please Write Legibly
Last name: First name:
Mailing address:
Service address (if different):
Phone: Number of full time residents: Year residence or building was
constructed:
Number of WaterSense® labeled toilets purchased and installed at this residence:
New toilet brand and model:
Please check to indicate that you have completed the following tasks: