To better understand our customers, and to serve you better, we would appreciate your answers to the following questions

: House type where refrigerator will be used: (Check all that apply.) Single family Own Rent Condo/Townhouse Primary residence Multi-family Vacation home

Use this mail-in rebate form to

Save $100 on an ENERGY STAR certified refrigerator or $150 on a super-efficient ENERGY STAR certified refrigerator.
Plus, get $50 for recycling your old refrigerator.
We’ll pick up and recycle your old, working refrigerator or freezer and you’ll receive a $50 reward. And, if you recycle a room air conditioning unit at the same time, you’ll receive an additional $25. To schedule a pickup, visit

Refrigerator Rebates
on ENERGY STAR® certified models.

How many people live in the home?__________________ Why did you buy a new refrigerator? (Check all that apply.) New purchase (does not replace broken unit) Replace broken unit Upgrade to better unit Energy savings Remodeling New home Better performance

How old is the refrigerator you are replacing?__________ What is the main reason you purchased an ENERGY STAR certified refrigerator? (Check one.) Energy savings Best price Rebate Size Best quality Quieter

Get energized about energy efficiency!
The BGE Smart Energy Savers Program offers a variety of services and incentives to help you save energy, save money and help the environment. Take advantage of:
• Lighting Discounts • Appliance Rebates • Refrigerator and Freezer Recycling Rewards • Quick Home Energy Check-up • Heating and Cooling System Rebates • Home Performance with ENERGY STAR® • ENERGY STAR® for New Homes • Small Business Energy Solutions • Energy Solutions for Business

Environmental Concerns Other _________________________________________ Have you previously purchased other ENERGY STAR certified products? Yes No Did you know about the mail-in rebate before you made your purchase? Yes No Did the rebate influence your decision to buy an ENERGY STAR appliance? Yes No

Learn more at or by calling 877.685.7377.

How did you hear about ENERGY STAR certified refrigerators? (Check all that apply.) BGE Website Radio Newspaper ad Retailer/salesperson News report/article TV ad Online Friend/relative/coworker Insert in utility bill Other_________________
Printed on recycled paper using environmentally friendly inks. This program supports the EmPOWER Maryland Energy Efficiency Act.

These programs support the EmPOWER Maryland Energy Efficiency Act.

Get more and save more with a $100 or $150 mail-in rebate for the purchase of an ENERGY STAR certified refrigerator.
When you choose an ENERGY STAR certified refrigerator, you’ll enjoy more than just energy savings and outstanding performance—you can get $100 or $150 back with the attached mail-in rebate from the BGE Smart Energy Savers Program®. $100 Rebate—Receive a $100 rebate on an ENERGY STAR certified refrigerator. $150 Rebate—Receive a $150 rebate on a superefficient ENERGY STAR certified refrigerator with an efficiency rating 25% better than the federal standard. For qualifying refrigerators, visit BGESmartEnergy. com/refrigerator to view ENERGY STAR’s detailed list of refrigerator ratings, and look in the “Percent better than Federal Standards” column for models that are 25% better or higher.

Get $100 or $150 back when you buy an ENERGY STAR certified refrigerator.
• Rebates are available to all BGE residential electric

BGE Electric Account Number: _________________________________________________ Name:____________________________________________ Account Address:__________________________________ City:_______________________ State: MD ZIP:_________ Home Phone:______________________________________ Work Phone (optional):______________________________ Email Address (optional):____________________________ Mailing Name and Address (if different from previous): _________________________________________________ _________________________________________________ City:_______________________ State:_____ ZIP:__________

customers regardless of electric energy supplier. Limit one certified refrigerator rebate, per BGE household, on rebates submitted beginning January 1, 2012, and while funds are available.
• Customer applying for rebate must be a BGE

“customer of record” living at the address noted on the application form.
• Requests must be postmarked no later than 30 days

from purchase date.
• Certified refrigerator must be purchased in Maryland, or

the buyer must demonstrate having paid the applicable Maryland sales and use tax.
• Rebate application must be accompanied by proof of

Information on your new ENERGY STAR certified refrigerator:
Brand:_____________________ Model #:______________ Purchase Price: $____________ Purchase Date:________ Name and address of store where purchased: _________________________________________________ _________________________________________________
By signing this form, I certify that I purchased the ENERGY STAR certified refrigerator noted above for the BGE service address above, and I am a BGE residential electric customer. I am providing the requested information solely to be eligible to participate in BGE’s Smart Energy Savers Program and request that the personal information supplied by me be treated as confidential to the maximum extent possible. I certify by my signature on this application that the ENERGY STAR certified refrigerator for which this rebate application is submitted was purchased at a Maryland retailer, or I have paid the applicable Maryland sales and use tax.

Save now and for years to come.
An ENERGY STAR certified refrigerator can save you more than $165 in energy costs over its lifetime compared to a new standard model.* In most households, the refrigerator is the single biggest energyconsuming kitchen appliance. Improvements such as high-efficiency compressors, enhanced insulation, and more precise temperature and defrost mechanisms all increase energy efficiency. For more ways to cut your energy use and save money with the BGE Smart Energy Savers Program, visit or call 877.685.7377.
*Source:, 2013

purchase (copy of sales receipt or invoice) and a copy of a recent BGE electric bill.
• $100 rebate is for an ENERGY STAR certified

refrigerator; $150 rebate is for a super-efficient ENERGY STAR certified refrigerator. The rebate paid will not exceed the purchase price of the appliance.
• If you are purchasing an appliance for a BGE

account in your tenant’s or landlord’s name, visit for an additional form required along with this form. Fill out completely. All information is required. Incomplete forms will delay or disqualify your rebate. I purchased (check one):  n ENERGY STAR certified refrigerator that qualifies for A the $100 rebate.  super-efficient ENERGY STAR certified refrigerator A with an efficiency rating of 25% better than the federal standard that qualifies for the $150 rebate. If the appliance for which this application is being submitted for a rebate does not meet the criteria for super-efficient, but is ENERGY STAR certified, the $100 rebate will be given.

Note: If this form is not signed, the rebate will not be processed.

Get $50 for recycling your old refrigerator!
Receive $50 for that old, less efficient refrigerator with BGE’s Refrigerator and Freezer Recycling Program. To schedule a pickup, visit

The following materials must be included to receive your rebate. Check the circles below to confirm that all items are included before mailing.  Completed rebate form  Dated copy of the sales receipt or invoice  Copy of recent BGE electric bill Mail to: BGE ENERGY STAR APPLIANCE REBATE 40 Washington St., Suite 2000 Westborough, MA 01581-1013
Please do not include rebate mail-in application form with your BGE bill payment. Allow 6–8 weeks for processing. Rebates must be postmarked no later than 30 days from purchase date.