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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 Condo/Townhousewhere refrigerator will be used: (Check all that apply.) Multi-family Own Rent Primary residence Vacation home

used: (Check all that apply.) Single family Condo/Townhouse Multi-family Own Rent Primary residence Vacation home How

Multi-familyused: (Check all that apply.) Single family Condo/Townhouse Own Rent Primary residence Vacation home How many

Own Rent Primary residence Vacation homeall that apply.) Single family Condo/Townhouse Multi-family How many people live in the home? Why did

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)Why did you buy a new refrigerator? (Check all that apply.) Replace broken unit Upgrade to

Replace broken unitall that apply.) New purchase (does not replace broken unit) Upgrade to better unit Energy savings

Upgrade to better unitpurchase (does not replace broken unit) Replace broken unit Energy savings How old is the refrigerator

Energy savingsbroken unit) Replace broken unit Upgrade to better unit How old is the refrigerator you are

How old is the refrigerator you are replacing?

savings How old is the refrigerator you are replacing? Remodeling New home Better performance What is
savings How old is the refrigerator you are replacing? Remodeling New home Better performance What is
savings How old is the refrigerator you are replacing? Remodeling New home Better performance What is

Remodelingsavings How old is the refrigerator you are replacing? New home Better performance What is the

New homeHow old is the refrigerator you are replacing? Remodeling Better performance What is the main reason

Better performanceis the refrigerator you are replacing? Remodeling New home What is the main reason you purchased

What is the main reason you purchased an ENERGY STAR certified refrigerator? (Check one.)

an ENERGY STAR certified refrigerator? (Check one.) Environmental Concerns Other Have you previously purchased

an ENERGY STAR certified refrigerator? (Check one.) Environmental Concerns Other Have you previously purchased

Environmental Concernsan ENERGY STAR certified refrigerator? (Check one.) Other Have you previously purchased other ENERGY STAR

Othercertified refrigerator? (Check one.) Environmental Concerns Have you previously purchased other ENERGY STAR certified

Have you previously purchased other ENERGY STAR certified products? Yes No

Did you know about the mail-in rebate before you made your purchase?

know about the mail-in rebate before you made your purchase? Did the rebate influence your decision

Did the rebate influence your decision to buy an ENERGY STAR appliance?

influence your decision to buy an ENERGY STAR appliance? Energy savings Best price Rebate Size Best

Energy savings

Best price

to buy an ENERGY STAR appliance? Energy savings Best price Rebate Size Best quality Quieter Yes

to buy an ENERGY STAR appliance? Energy savings Best price Rebate Size Best quality Quieter Yes

Rebate

Size

ENERGY STAR appliance? Energy savings Best price Rebate Size Best quality Quieter Yes No Yes No

ENERGY STAR appliance? Energy savings Best price Rebate Size Best quality Quieter Yes No Yes No

Best quality

Quieter

Energy savings Best price Rebate Size Best quality Quieter Yes No Yes No How did you
Energy savings Best price Rebate Size Best quality Quieter Yes No Yes No How did you

Yes

savings Best price Rebate Size Best quality Quieter Yes No Yes No How did you hear

No

Yes

Best price Rebate Size Best quality Quieter Yes No Yes No How did you hear about

No

How did you hear about ENERGY STAR certified refrigerators? (Check all that apply.)

BGESTAR certified refrigerators? (Check all that apply.) Retailer/salesperson News report/article Website Radio

Retailer/salespersonSTAR certified refrigerators? (Check all that apply.) BGE News report/article Website Radio Newspaper ad

News report/article(Check all that apply.) BGE Retailer/salesperson Website Radio Newspaper ad Friend/relative/coworker Insert

that apply.) BGE Retailer/salesperson News report/article Website Radio Newspaper ad Friend/relative/coworker Insert

Websitethat apply.) BGE Retailer/salesperson News report/article Radio Newspaper ad Friend/relative/coworker Insert in

Radioapply.) BGE Retailer/salesperson News report/article Website Newspaper ad Friend/relative/coworker Insert in utility bill

BGE Retailer/salesperson News report/article Website Radio Newspaper ad Friend/relative/coworker Insert in utility bill

Newspaper ad

Friend/relative/coworkerNews report/article Website Radio Newspaper ad Insert in utility bill Other TV ad Online Use this

Insert in utility billWebsite Radio Newspaper ad Friend/relative/coworker Other TV ad Online Use this mail-in rebate form to Save

Newspaper ad Friend/relative/coworker Insert in utility bill Other TV ad Online Use this mail-in rebate form

Other

TV ad

Friend/relative/coworker Insert in utility bill Other TV ad Online Use this mail-in rebate form to Save

Online

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 BGERecycleMyOldFridge.com.

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

Learn more at BGESmartEnergy.com or by calling

877.685.7377.

more at BGESmartEnergy.com or by calling 877.685.7377 . Printed on recycled paper using environmentally friendly
more at BGESmartEnergy.com or by calling 877.685.7377 . Printed on recycled paper using environmentally friendly

Printed on recycled paper using environmentally friendly inks.

These programs support the EmPOWER Maryland Energy Efficiency Act.

programs support the EmPOWER Maryland Energy Efficiency Act. $100–$150 Refrigerator Rebates on ENERGY STAR ®
programs support the EmPOWER Maryland Energy Efficiency Act. $100–$150 Refrigerator Rebates on ENERGY STAR ®
programs support the EmPOWER Maryland Energy Efficiency Act. $100–$150 Refrigerator Rebates on ENERGY STAR ®

$100–$150

Refrigerator

Rebates

on ENERGY STAR ® certified models.

This program supports the EmPOWER Maryland Energy Efficiency Act.

ENERGY STAR ® certified models. This program supports the EmPOWER Maryland Energy Efficiency Act. BGESmartEnergy.com
ENERGY STAR ® certified models. This program supports the EmPOWER Maryland Energy Efficiency Act. BGESmartEnergy.com
ENERGY STAR ® certified models. This program supports the EmPOWER Maryland Energy Efficiency Act. BGESmartEnergy.com

BGESmartEnergy.com

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 super- efficient 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.

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 energy- consuming 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 BGESmartEnergy.com or call 877.685.7377.

*Source: energystar.gov, 2013

Get $100 or $150 back when you buy an ENERGY STAR certified refrigerator.

Eligibility

Rebates are available to all BGE residential electric 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

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 BGESmartEnergy.com/Leasing 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):

An ENERGY STAR certified refrigerator that qualifies for the $100 rebate .

An ENERGY STAR certified refrigerator that qualifies for the $100 rebate.

A super-efficient ENERGY STAR certified refrigerator

A

super-efficient ENERGY STAR certified refrigerator

with an efficiency rating of 25% better than the federal standard that qualifies for the $150 rebate.

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 BGERecycleMyOldFridge.com.

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.

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:

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.

Signature:

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

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.

BGE bill payment. Allow 6–8 weeks for processing. Rebates must be postmarked no later than 30
BGE bill payment. Allow 6–8 weeks for processing. Rebates must be postmarked no later than 30
BGE bill payment. Allow 6–8 weeks for processing. Rebates must be postmarked no later than 30