Ductwork Replacement Program Application

Important: Ductwork must be new and application must be submitted within six (6) months of installation. A copy of itemized invoice/receipt from a licensed contractor must be attached.

Eligibility Requirements:
1. Applicant must be PWC residential Customer with active electric service in good standing.
2. Applicant must be homeowner and account holder of record where ductwork is being replaced.
3. Applicant must apply for bill credit within six (6) months of purchase and installation date.
4. Work must be completed by a licensed contractor.
5. Existing ductwork must be at least fifteen (15) years old. This bill credit is for retrofit applications only and does NOT apply to new construction.
6. Applicant must submit original or copy of the paid and dated receipt or invoice within six (6) months of purchase and installation.
7. Applicant must submit all paperwork required of this Program through attachments on this form OR by emailing Customer.Programs@FayPWC.com
8. Applicant must agree to Terms and Conditions of this Program.

Applicant Information
PWC Account Number
Name Name First Last
Address Address
Street Address City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Email
Text Messaging Available?

Text Messaging Available? Yes No
Cell Phone Number Cell Phone Number - ### - ### ####
Are you the owner or renter?

Are you the owner or renter? Owner Renter
Ductwork Replacement Information

$200 Bill Credit
Contractor
Date of Installation: Date of Installation: / MM / DD YYYY
Total Price (without Tax):
Was the old ductwork more than 15 years old?

Was the old ductwork more than 15 years old? Yes No
Please attach a copy of your receipt(s)

Attach Files
Signature

I have read, understand, and agree to the Program Terms and Conditions, disclaimers, limitations of liability and release as it pertains to this Program. I declare under penalty of perjury of the laws of the State of North Carolina that all of the information provided herein is true to the best of my knowledge. I hereby certify that I am the authorized account holder at the address listed above.
Applicant Signature

Draw or Type

Draw your signature into the box above. I understand this is a legal representation of my signature. Clear

Full Name

Draw your signature into the box above. I understand this is a legal representation of my signature.

Ductwork Replacement Program Application

Ductwork Replacement Program Application

Applicant Information

Ductwork Replacement Information

Signature