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Community Solar Project


Renewable Energy System Cost Recovery Certification
82.16 RCW
First, contact the utility serving your property to confirm Department of Revenue Tax Reporting Number
it is participating in this program and to receive its For official use only
application procedures for this incentive payment.
Instructions for Filing: Please mail or fax this
certification form to the Washington State Department of Name and Physical Address of Community Solar
Revenue at the address below. The Department will: (1) Project
forward this form to the Climate and Rural Energy
Development Center at Washington State University, and
(2) advise the applicant within 30 days of receipt of this
form whether the renewable energy system qualifies for
the investment cost recovery incentive program.
Definitions:
Customer-generated electricity: A community solar Utility owned? Yes No
project or the alternating current electricity that is
Contact Person - Name, Mailing Address and Phone
generated from a renewable energy system located on an
Number
individual’s, businesses’, or local government’s real
property that is also provided electricity generated by a
light and power business. Except for community solar
projects, a system located on a leasehold interest does not
qualify under this definition.
Solar inverter: The device used to convert direct current
to alternating current in a photovoltaic cell system. Phone Number: Required
Photovoltaic cell: A device that converts light directly
Does the electricity produced meet the definition of
into electricity without moving parts.
“customer generated electricity?”
Solar module: The smallest nondivisible self-contained
Yes No
physical structure housing interconnected photovoltaic
cells and providing a single direct current electrical output. What does the renewable energy system produce
Mail to: Department of Revenue electricity with?
Taxpayer Account Administration
PO Box 47476 ♦ Solar inverters and solar modules manufactured
Olympia WA 98504-7476 in Washington State
FAX to: (360) 586-0527 ♦ A solar inverter manufactured in Washington
State
♦ A solar module manufactured in Washington
For Official Use Only − Approval Signatures State
Department of Revenue ♦ Solar equipment manufactured outside of
Washington State
Date: / / Can the electricity be transformed or transmitted for
entry into or operation in parallel with electricity
Climate & Rural Energy Development Center − WSU transmission and distribution systems? Yes No
What is the permit number and the date the Community
Date: / / Solar Project received its final electrical permit from the
local jurisdiction?
Permit No: Date:
The information provided is true, complete, and correct to the
best of my knowledge and belief under penalty of perjury.

Signature:

For tax assistance, visit dor.wa.gov or 1-800-647-7706. To inquire about the availability of this document in an alternate format for the visually
impaired, please call (360) 705-6715. Teletype (TTY) users may call 1-800-451-7985.
REV 41 0110e (09/09/09) Print This Form