INCENTIVE APPLICATION FOR PROJECTS COMPLETED BY 12/31/2024
Complete all sections. Incomplete applications cannot be processed and will delay payment of incentives. Applications must be submitted within 60 days of completed project installation , no later than January 31, 2025. Visit focusonenergy.com/catalogs for additional copies of this form. section 1 ACCOUNT AND CUSTOMER INFORMATION Tax Identification Number (Check one) q FEIN or q SSN If you use a Social Security Number (SSN) as your Tax Identification Number, do not provide it below . You will be contacted by the program via email to provide a copy of your W-9 using a secure online portal, if it is not already on file. You must list an email address in Section 3 . _______________________________________________________ FEIN TAX CLASSIFICATION OF CUSTOMER (Check one. Required for all businesses, including nonprofits.) q Sole Proprietorship q S Corporation q LLC - Partnership
If Focus on Energy has a question about this application, we should contact: q Customer q Trade Ally q Other_________________ section 4 TRADE ALLY INFORMATION _______________________________________________________ TRADE ALLY CONTACT NAME _______________________________________________________ PRIMARY PHONE # EMAIL ADDRESS _______________________________________________________ TRADE ALLY COMPANY NAME _______________________________________________________ ADDRESS _______________________________________________________ CITY STATE ZIP section 5 PAYMENT INFORMATION Payee is responsible for any associated tax consequences. Make incentive check payable to: q Customer q Trade Ally q Other Payee If Other Payee is selected, the relationship to the utility account holder must be identified below: q Tenant q Building Owner q Other (specify) ___________________ FOR ALL PAYEES Mail check to: q Customer Address q Job Site Address q Trade Ally Address q Alternate Address _______________________________________________________ COMPANY NAME _______________________________________________________ ADDRESS _______________________________________________________ CITY STATE ZIP _______________________________________________________ ATTENTION TO (OPTIONAL) For Trade Ally and Other Payees Trade Allies must be registered with the Program and have a current W-9 on file to receive payment. Tax Identification Number (Check One) q FEIN q SSN If you use a Social Security Number (SSN) as your Tax Identification Number, do not provide it below . You will be contacted by the program via email to provide a copy of your W-9 using a secure online portal, if it is not already on file. You must list an email address below . _______________________________________________________ FEIN Tax Classification of Payee (Check one. Required for all businesses, including nonprofits.) q Sole Proprietorship q Individual q Single-Member LLC q C Corporation q S Corporation q Partnership q LLC - C Corp q LLC - S Corp q LLC - Partnership q Other ____________________________ Payee Contact Information _______________________________________________________ NAME EMAIL ADDRESS
q C Corporation q LLC - C Corp
q LLC - S Corp
q Partnership
q Single-Member LLC q Other:
_______________________________________________________ OWNER NAME (REQUIRED IF SSN IS USED AS TAX IDENTIFICATION NUMBER) _______________________________________________________ COMPANY NAME _______________________________________________________ LEGAL ADDRESS (AS SHOWN ON COMPANY W-9) _______________________________________________________ CITY STATE ZIP _______________________________________________________ WHO DID YOU WORK WITH FROM FOCUS ON ENERGY? (CONTACT NAME) section 2 JOB SITE INFORMATION (Refer to your utility bills for account numbers below.) _______________________________________________________ JOB SITE BUSINESS NAME _______________________________________________________ ELECTRIC UTILITY AT JOB SITE ELECTRIC ACCOUNT # _______________________________________________________ GAS UTILITY AT JOB SITE GAS ACCOUNT # q JOB SITE ADDRESS IS SAME AS LEGAL ADDRESS q JOB SITE ADDRESS IS DIFFERENT (COMPLETE BELOW) _______________________________________________________ NUMBER OF UNITS AT JOB SITE: _______________________________________________________ JOB SITE ADDRESS _______________________________________________________ CITY STATE ZIP section 3 CUSTOMER CONTACT INFORMATION _______________________________________________________ JOB SITE CUSTOMER CONTACT NAME _______________________________________________________ PRIMARY PHONE # EMAIL ADDRESS q I opt in to receive program updates. Preferred method of contact: q Call q Email q Text
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