Natural Gas Appliance Rebate Form Natural Gas Appliance Rebate Form Qualifying Participants 1. Existing customers of Marshall County Gas District*. 2. New customers of Marshall County Gas District. 3. Participant must own premises.Procedure for Participating 1. Participants are responsible for purchasing and installation of natural gas appliance. 2. Marshall County Gas District WILL NOT BE RESPONSIBLE for any warranties and/ or liabilities associated with the natural gas appliance(s) or installation of the natural gas appliance(s). 3. Participants must present the following: - Valid proof of purchase (original receipt from merchant or legible copy of the original receipt) for each qualifying appliance. - The proof of purchase must be dated within 6 months of applying for natural gas rebates, unless it is new construction. - Serial and Model number of furnace. - Complete MCGD Rebate Form. 4. A MCGD serviceman has to visually inspect the gas appliance(s) to ensure installation. Installation MUST be completed. Inspection times are 7:30 to 4:30, Monday -Friday. 5. The credit will be reflected on your MCGD account in the amount of the proper rebate, after all paperwork and inspection is completed. This will be credited within 30 days of visual inspection.Qualifying Appliances(Required) Natural Gas Furnace (no hybrid/piggy back/dual fuel) - $1000 Natural Gas Direct-Vent Furnace - $400 Natural Gas Water Heater - $200 Natural Gas Water Heater (switch from electric) - $400 Natural Gas Tankless Water Heater - $300 Cooking Top/Range (Either Or) - $100 Clothes Dryer - $200 Lights - $200 Grills - $50 Logs - $50 Wall Heater - $50 Customer InformationName(Required) First Last Service Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone(Required)Customer ID(Required)Proof of PurchaseMax. file size: 256 MB.Signature(Required)Date(Required) MM slash DD slash YYYY *Customers who have participated in the gas appliance program within the past 5 years are not eligible for any rebates. All new and existing customers are responsible for the purchasing and installation of the natural gas appliance(s). All participation criteria must be met in order to receive the credit on your natural gas account. This offer is not available to Commercial Customers.Consent(Required) I agree to the terms and conditions list above. Δ