WaterSmart Business rebate form

WaterSmart Business Rebates are now open.

Business Name *

ABN *

Mailing Address *

Site Address *

Contact Name *

Position

Telephone

Mobile *

Email Address *

Primary Purpose of Your Business

Product and Services Information

Type of Product/Services you are claiming *

Place(s) of purchase *

Item(s) replaced (make & model) *

Type of product/service (Tick all that apply) *

• Dual Flush Toilets*
• Waterless or Low Flow urinals*
• Showerheads
• Cut off Showerhead*
• Flow control devices
• Pre-einse nozzles
• Hand held rinse sprays
• Washing Machine (domestic/commercial)
• Dishwashers (domestic/commercial)
• Glass Washers
• Waterless Wok Stove*
• Rainwater Tanks*
• Substitution of mains drinking water with alternate water sources such as groundwater or farm dams*
• Upgrades to existing water supply systems resulting in permanent water savings*
• Wastewater recycling to reduce drinking water consumption within business operations*
• Water Audit by a licensed plumber*
• Data Loggers*

* May require installation by a licensed plumber or tradesman

Have all permits/licences been obtained? *

• Yes
• No
• None required

If yes provide details

Have you consulted with a technical expert about the project? *

• Yes
• No
• None required

If yes provide details

Project Costs

Total dollar ($) amount of your purchase(s), installation costs and delivery costs *

Funding amount from another source ($ amount & source e.g COGG) *

Rebate amount requested (max $1,500) *

Supporting Documentation

Attach original invoice(s) and receipt(s) *

Attach Plumbing Industry Commission (PIC) certificate of compliance if required

Attach photos of completed project

Attach any additional information relevant to this claim

Declaration

Name *

Position *

Date *