2024 All Appliance Rebate Form

I am submitting a rebate for

$25 Clothes Washer

$25 Dehumidifier

$25 Electric Dryer

$50 Freezer (15 cubic ft min)

$50 Refrigerator (15 cubic ft min)

Member Information

Name

Account Number

Phone

Address where appliance is installed

City/Town

State/Province

ZIP/Postal Code

By checking this box, I certify the product is installed at the address listed above which represents a valid cooperative account

Today's Date

Equipment Information

Clothes Washer Manufacturer

Clothes Washer Model Number

Dehumidifier Manufacturer

Dehumidifier Model Number

Electric Dryer Manufacturer

Electric Dryer Model Number

Freezer Manufacturer

Freezer Model Number

Refrigerator Manufacturer

Refrigerator Model Number

Retailer Information

Retailer/Store Name

Location

Rebates are available for the purchase of new ENERGY STAR® rated products purchased on or after January 1, 2024. The purchased products must be installed where electricity is supplied by the cooperative. Rebates submittal must follow the guidelines as outlined below. Crow Wing Power is not responsible for inaccurate information supplied by appliance dealers. Rebates will be issued only for products on the current list of ENERGY STAR® rated products as of the purchase date. To verify ENERGY STAR® certification for appliances and lighting, visit www.energystar.gov.

Sales Receipt

Upload dated sales recipt within 90 days of purchase.

One file only.
100 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Equipment Information

Crow Wing Power is an equal opportunity provider and employer.