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Toilet Rebate Program Application

The Township of Cavan Monaghan is implementing a Toilet Rebate Pilot Program to reduce water use in homes within the Township; to lower the impacts on the environment; to reduce costs to the users of the water and wastewater systems; and to accommodate further allocation for growth thereby further reducing overall costs.

Toilets are the highest water user within a home and new models are capable of using half to a third of the consumption of existing toilets.

Residents of the Township of Cavan Monaghan are eligible for a $100 rebate per toilet replaced.

Please complete the application and a staff representative will contact you directly.

Please note: Completion of this form does not guarantee a credit will be made to your account.

Date Requested:

Municipal Water Account Number:

Customer's Name on the Account:

Customer's Phone Number:

Customer's Email (optional):

Service Address:

Number of toilet credits requested:

Toilet purchase sales receipt number:

Please upload a copy of the sales receipt for the toilet.

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Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif

Description of existing and replacement toilets i.e. L/flush, location, make and model etc.

As the customer for the above property, I hereby apply for a credit under the Township of Cavan Monaghan's Toilet Rebate Program. I confirm that the above information is true and accurate.

Yes

Customer's Signature:

Clear