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Residential LED Light Bulb Rebate Form

  1. NOTE: Submitting this document electronically will require you to upload documentation such as sales receipt, etc.  Please do not send sensitive information.

  2. Anoka Municipal Utility (AMU) Rebates
  3. Check this box to acknowledge that you have read and agree to our rebate policy Rules & Requirements.*
  4. Select Qualifying Purchase Date:*

    Customers must apply for rebates within twelve (12) months of the purchase date shown on the sales receipt.

  5. Anoka Municipal Utility (AMU) Customer Information

    You must have an address that is serviced by Anoka Municipal Utility (AMU). 

  6. Anoka Municipal Utility (AMU) is my electric service provider.*
  7. Rebate amount will be credited to your AMU billing account. No need for a mailing address. This must be the location of installation for the rebate. 

  8. Building Type*
  9. Retailer Information
  10. Receipt(s) submitted must include Retailer Information and Purchase date along with product information for proof of purchase.

    Take a picture from your phone, a screen shot, or scanned copy of original receipt. 

  11. Upload Another Receipt?*
  12. Upload Another Receipt?*
  13. Upload Another Receipt?*
  14. Upload Another Receipt?*
  15. Equipment Information

    Bulbs must save energy to qualify.  Limit of $50.00 rebate per year.

  16. Energy Saving LED Bulbs?*

    Replacement bulb less wattage than previous bulb. Does not need to be ENERGY STAR®.

  17. Find on LED package or Replacement bulb wattage

  18. Find on LED package

  19. Cost per package x Quantity of Packages

  20. Add Another Bulb Type?*
  21. Add Another Bulb Type?*
  22. Add Another Bulb Type?*
  23. Add Another Bulb Type?*
  24. (Limit of $50.00 per year)

    If rebate is approved,  amount will be credited to your AMU billing account.

  25. Disclaimer & Signature
  26. Check this box to agree to the following:*
  27. Electronic Signature Agreement*
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
  28. Leave This Blank:

  29. This field is not part of the form submission.