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Equipment Application

Select equipment based on the energy ratings and terms and conditions shown on the Residential Rebate Schedule. Equipment must be installed in a home within Iowa and MidAmerican Energy Company must supply the natural gas or electricity fueling the water heater. Only approved equipment is eligible for energy efficiency rebates. After purchasing and installing qualifying equipment: 1.  Complete this Equipment Application, including signature(s). 2.  Attach a dated invoice and sales receipt from your dealer, including manufacturer’s name, model/serial number and quantity of equipment purchased and installed. Equipment must be installed between Jan. 1, 2013, and Dec. 31, 2013. Rebate applications must be postmarked by Jan. 31, 2014, to qualify for 2013 rebate program. Equipment included in the EnergyAdvantage® New Homes program comprehensive incentive is not eligible for additional incentives in the Residential Equipment program. 3. Allow four to six weeks for processing. 4. Questions? Call 800-894-9599. Submit applications to: MidAmerican Energy Company EnergyAdvantage Programs P .O. Box 4628 Des Moines, IA 50305-4628

DISCLAIMER: MidAmerican Energy Company does not guarantee that installation and operation of energy-efficient equipment will result in reduced usage or in cost savings. The manner in which a customer uses and maintains energy-efficient equipment affects potential cost savings. MidAmerican Energy Company makes no warranties, expressed or implied, with respect to any equipment purchased or installed, including, but not limited to, any warranty of merchantability or fitness for a particular purpose. In no event shall MidAmerican Energy Company be held liable for any incidental or consequential damages or injuries resulting from defective equipment or installation. MidAmerican Energy Company reserves the right to cancel or change these programs at any time. MidAmerican Energy Company’s acceptance of this application does not guarantee payment of rebate or acceptance of financing.

MidAmerican Energy WATER HEATER Rebate
q Natural Gas Water Heater

0.62 to 0.66 energy factor........................ $50 0.67 to 0.79 energy factor...................... $100 0.80 energy factor or greater................... $300
(storage tank 40 gallons or greater, instantaneous not eligible)

(storage tank 20 gallons or greater or natural gas instantaneous eligible)

q Electric Water Heater

0.93 energy factor or greater..................... $50

Manufacturer____________________________________________ Model #________________________________________________ Serial #_________________________________________________ Installed cost____________________________________________ Date installed____________________________________________ Installer___________________________________ q Self-installed Dealer/installer signature_________________________________

Customer Information
MidAmerican Energy account number (found on bill; first seven digits only) Name on account________________________________________ Installation address_______________________________________ City ______________________ State _____ Zip________________ Rebate payable to: Name__________________________________________________ Address_________________________________________________ City _______________________________ State _____ Zip________ Daytime phone #________________________________________ Evening phone #_________________________________________

Customer Agreement

My signature indicates consent to and agreement with all program terms and conditions. It certifies that all information in this application is correct and that all of the listed new equipment has been purchased, installed and is operating at the indicated location. I understand that MidAmerican Energy Company reserves the right to inspect and verify installation before and after issuing payment.

_______________________________ ________________
Customer signature Date

(Must be a MidAmerican Energy customer and live in Iowa.)

Please attach sales receipt.

Questions? Call 800-894-9599 www.midamericanenergy.com/iowa_rebates

Federal Tax Credits for Energy Efficiency Consult a qualified tax advisor or visit www.energystar.gov/taxcredits for details on any applicable federal tax credits or incentives available for installation of energy-efficient equipment.

800-894-9599 www.midamericanenergy.com/ee


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