Water Wise Account Credit - PDF document

1 Water Wise Account Credit Thankyo
Water Wise Account Credit ThankyouforsupportingSCWA’swaterconservationinitiative.Wewouldliketoshowour appreciation by giving our customers a credit to their account for purchasing conservation device(s). To receive your credit , fill out the form below and submit the form either by mail or email with attached original receipt(s). Please allow 4 - 6 weeks for credit to post to your SCWA account. Item must be purchased after April 30 th , 2016. Customer Information Name: ______________________________ Account Number: _______________ __________ Address: _____________________________________________________________________ Telephone: _______________________ Customer Signature: _________________________ The maximum credit is $50 per account. This program is limited to the following devices and credits:  Rain sensor device - receive up to a $50 credit, not to exceed purchase price  Smart i rrigation controller – receive up to a $50 credit, not to exceed purchase price  EPA WaterSense shower head - receive up to a $10 credit, not t o exceed purchase price  Faucet aerator - receive up to a $10 credit, not to exceed purchase price  Smart Valve - receive up to a $ 5 0 credit, not to exceed purchase price Attach original receipt(s) for each item: List explanation for each item below. Purchase Date Item Description Store Name Price Quantity Mail credit request to: Suffolk County Water Authority, 4060 Sunrise Highway, Oakdale, NY 11769 Attention: Water Wise Account Credit Or Email to: waterwiseclub@scwa.com For questions regarding your credit, please email: waterwiseclub@scwa.com For Internal Use Only Approval Date Approved By Credit Amount