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Clean & Check
$50 Consumer Rebate
Based upon signature of the SMART Member performing the work, the homeowner or business owner and the contractor, I Want SMART will make payment to the homeowner or business owner pursuant to its Rebate Program. The SMART Member, homeowner or business owner, and contractor certify that the information printed here is true.
___________________________ _____________ ________________________
Member Print Name IA Number Member Signature
_______________________________________ _____________
Homeowner/Business Owner Signature Date
_______________________________________
Contractor Name
Please return completed form to:
I Want SMART Rebate Processing, 11831 Beverly Park Rd. Bldg B-2, Everett, WA 98204