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Phone Zip Date Member Signature Account State Residential Farm Commercial Industrial Institution/Government Other REBATE INFORMATION Please fill in gray shaded boxes for requested rebates Equipment Rebate CFL Bulb LED Bulb Occupancy Sensor LED Exit Sign Quantity Total Rebate Enter information for fixtures with same lumen output per line. Continue on back of form if needed. LED Fixture 1 per 400 lumens in the fixture Number of Lumens per Fixture Number of Fixtures...
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