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Customer Information
Available Devices in Service Area
Purchased Information
Program Survey

Step 1 of 4

Customer Information/Installation Address

Note: Estimated rebate amount may be incorrect if the wrong water agency is selected. Fields marked with an * are required.

* First Name:
 
* Last Name:
 
* Street Address:
 
Apt/Unit:

             Entering your zip code will automatically populate the city and state of your address.

* Zip:
 
* City:
* State:
 
* Water Agency:
 
Account Number:
Mailing Address for Rebate Check

Note: PO BOX format (PO BOX 123...)

Mailing address is the same address listed above
*Street Address/PO Box:
 
Apt/Unit:
* Zip:
 
* City:
* State:
 
Contact Information

Note: Email address will be used to notify customer of rebate status updates.

* Contact First Name:
 
* Contact Last Name:
 
* Email:
   
* Confirm Email:
   
* Phone Number:
   
* Relationship to Account Holder: