Renewable Energy Mitigation Program (REMP)

Appliance Rebate Form

NAME___________________________________ PHONE______________________________

PHYSICAL ADDRESS______________________________________________________________
(Must be a fulltime Roaring Fork Valley resident or business to qualify)

MAILING ADDRESS______________________________________________________________

E-MAIL ADDRESS________________________________________________________________

Full time Roaring Fork Valley resident or business? YES NO

Electric Utility? Holy Cross, City of Aspen, City of Glenwood Springs, Xcel, Other

City of Aspen Water customer? YES NO

Product Information
Appliance Type:______________________________________________

Manufacturer:_______________________________________________

Model Number:______________________________________________

Date of Purchase:_____________________________________________

For dishwashers and clothes washers, please estimate the number of loads per week _______

For clothes washers, CEE tier number (can be found on our website)_______

Number of residents in household/building _______

Rebate requirements:
 Fulltime Roaring Fork Valley resident or business (see rebate guidelines for defined area)
 Application must be submitted within 90 days of purchase
 Only one rebate per household per appliance type in 5 years
 Model number on proof of purchase

Signature_______________________________________ Date__________________________

Don’t Forget to Attach a Copy of Your Receipt!

CORE, P.0. Box 9707 Aspen, CO 81612 970‐544‐9808 www.aspencore.org