Purchaser signature Date

Installer phoneInstaller name (if different from purchaser name)

It is the responsibility of the purchaser to ensure that the program requirements are met. If program requirements are not met, no rebate will be paid.

Return completed form with required signature and a detailed copy of the retailer receipt/invoice to:

CenterPoint Energy Smart Thermostat Rebate P.O. Box 59038 Minneapolis, MN 55459-0038

Retailer name

RETAILER AND INSTALLER INFORMATION (Complete the entire section - please print)

2020 Date of installation Complete model #

Brand

THERMOSTAT INFORMATION (Complete the entire section - please print)

Purchaser email address Alt phonePhone

RenterBuilder AgencyLandlordOwnerPurchaser Type (select one)

Rebate check mailing address, city, state, and ZIP (if different from installation address)

Rebate check payable to:

PURCHASER INFORMATION (Equipment purchaser and rebate check recipient - please print)

Replacement (existing home) New constructionType of Installation (select one)

Type of Building (select one) Single-family home Townhome Two-plex to four-plex

Installation address, city, state and ZIP

CenterPoint Energy Gas Account Number for the address where new thermostat was installed

INSTALLATION INFORMATION (CenterPoint Energy service and equipment installation address - please print)

RESIDENTIAL SMART THERMOSTAT REBATE OKLAHOMA

This rebate is for new qualifying thermostats installed in a home with a gas furnace as primary heating source.

Program dates: Jan. 1, 2020 through Dec. 31, 2020

1) Review the Terms & Conditions on the back of this form to ensure all program requirements are met. 2) Limit one qualifying thermostat per gas service address. 3) Complete the entire application, including required signature. 4) Attach a clear copy of the retailer receipt/sales invoice. 5) Application must be submitted in the same calendar year that the equipment was installed.

White - CenterPoint Energy Yellow - Customer/Purchaser CNP 1402 (1-2020)

Heat PumpAir ConditionerElectric FurnaceGas FurnaceType of Heating System in Home (check all that apply)

Store location, city and state

Type of Retailer (select one)

Store

Online

RESIDENTIAL THERMOSTAT REBATE TERMS & CONDITIONS The qualifying equipment must be installed in an Oklahoma home served with natural gas from CenterPoint Energy between Jan. 1 and Dec. 31, 2020. All completed applications must be postmarked by Dec. 31, 2020 to be considered for a rebate.

Equipment installed under warranty replacement does not qualify for the rebate. CenterPoint Energy reserves the right to inspect the installed equipment.

Rebate applies to new equipment only. Refurbished models are not eligible for this rebate.

Equipment must be listed on the current manufacturers website.

Rebate cannot exceed the purchase price of the unit.

NEW CONSTRUCTION INSTALLATIONS For eligible New Construction installations, the building contractor should negotiate with homeowners to determine who receives the rebate. If you are building a new home, you must obtain an invoice from your builder or the retailer/dealer.

CENTERPOINT ENERGY GAS ACCOUNT NUMBER Customers can obtain their gas account number from their monthly bill statement, or online at CenterPointEnergy.com/MyAccount.

PROOF OF PURCHASE AND INSTALLATION A clear copy of the dated retailer receipt/invoice must list the qualifying thermostat as a purchased item and correspond with the equipment listed on the application. The receipt must describe the smart thermostat that was purchased. It cannot be a packing list, recall or generic receipt. CenterPoint Energy is unable to accept applications that do not include all of the requested information.

PROCESSING Completed rebate forms will be processed in the order in which they are received and are paid on a first-come, first served basis. Account number must be activated for installation address in order for rebate to be processed. CenterPoint Energy is not responsible if the retailer/dealer does not provide accurate information about the amount of a rebate or equipment eligibility. Rebate qualifications and amounts are subject to change. CenterPoint Energy Conservation Improvement Program (CIP) rebate programs may be cancelled or changed at any time. CenterPoint Energy issues a cash rebate not utility bill credits. Please allow 8 weeks to receive payment in the mail from the time that CenterPoint Energy receives your completed paperwork. If you haven't received payment after 8 weeks, please call 612-399-1545 or email RebateCenter@CenterPointEnergy.com.

Rebate checks are issued from our Houston, TX office and expire in 90 days from the date that the check was issued.

APPLICATION CHECKLIST SEND COMPLETED APPLICATION TO: □ All fields on form are completed Residential Smart Thermostat Rebate □ Purchaser signature CenterPoint Energy □ Dated receipt/sales invoice from retailer is attached to rebate form PO Box 59038 Minneapolis, MN 55459-0038

Rebate Type of Installation Type of Thermostat

Wi-Fi LearningReplacement or New Construction$60