Smart Irrigation Controller Retrofit Rebate Application

2. Rebate Information
   This rebate is intended to replace or upgrade the old controllers with new, weather-based technology. The rebate is offered one-time per service location, and must be installed in the Town's water service area.

   This rebate is intended to replace or upgrade the old controllers with new, weather-based technology. The rebate is offered one-time per service location, and must be installed in the Town's water service area.

4. 1. Account Information

6. Water Account Name*

7. Water Account Number

9. Date Attended Water Wiser Workshop

   Qualified applicants are required to attend a Water Wiser Workshop.

10. Photo Identification

    Please attach a copy of your photo identification for the Affidavit of Lawful Presence you will be asked to sign during the application process.

14. 2. Installation Data

16. Name*

18. Address*

20. City*

21. State*

22. Zip Code*

26. 3. Contact Information

28. Contact Person*

29. Last Name*

31. Phone Number

32. Best Time to Call

34. Email Address

38. 4. Traditional Controller Being Replaced
    To be eligible for a rebate, you are required to bring in the traditional controller that was replaced as part of the application. The old controller will be recycled by the Town of Castle Rock.

    To be eligible for a rebate, you are required to bring in the traditional controller that was replaced as part of the application. The old controller will be recycled by the Town of Castle Rock.

40. Manufacturer / Make*

41. Model Number*

45. 5. "New" Smart Irrigation Controller Information
    The controller must be installed on a fully operational automatic irrigation system, must be new and meet qualifying criteria. Actual water savings may vary.

    The controller must be installed on a fully operational automatic irrigation system, must be new and meet qualifying criteria. Actual water savings may vary.

47. Manufacturer / Make*

48. Model Number*

49. Date Purchased*

51. Where Purchased*

52. Location*

    (City)

53. Attach Copy of Original Receipt

55. Submittal Information
    Submission of the online application is not considered complete until the AFFIDAVIT OF LAWFUL PRESENCE is signed and returned by the applicant. Once you hit "submit" you will receive a confirmation and affidavit. Please print the affidavit and return to the Program Administrator. Your rebate can not be processed without this signed affidavit. Complete, rebate applications will be processed in the order of receipt. Rebate checks are generally issued within three to six weeks after receipt of a completed application.

    Submission of the online application is not considered complete until the AFFIDAVIT OF LAWFUL PRESENCE is signed and returned by the applicant. Once you hit "submit" you will receive a confirmation and affidavit. Please print the affidavit and return to the Program Administrator. Your rebate can not be processed without this signed affidavit. Complete, rebate applications will be processed in the order of receipt. Rebate checks are generally issued within three to six weeks after receipt of a completed application.

57. Email Address

    This field is not part of the form submission.

Leave This Blank:


59. 1. Receive an email copy of this form.
60. Email address

    This field is not part of the form submission.

61. Submit

* indicates a required field