2019 LAWN & GARDEN EQUIPMENT REBATE

Name _________________________________________

Street ________________________________________

City/State/Zip___________________________________

Phone ________________________________________

Indicate up to two of the following you are applying for: $25 rebate for purchase of “clean” lawn mower (electric or push-reel mower)

$25 rebate for recycling gas lawn mower (gas mower must be properly drained of oil/gas before recycling)

Rebate Form

$25 rebate for full season of “clean” lawn care service.

$25 rebate for purchase of other qualifying “clean” (electric or battery-powered) lawn and garden equipment (please specify type of equipment) leaf blower string trimmer edger hedge trimmer chain/pole saw cultivator/tiller

Affidavit

Restrictions on Public BenefitsPursuant to C.R.S. section 24-76.5-103(4)(b)

I _____________________________________, swear or affirm under penalty of perjury under the laws of the State of Colorado that (check one of the following): I am a United States citizen I am not a U.S. citizen but am lawfully present in the United States pursuant to Federal law.

I understand that this sworn statement is required by law because I have applied for a public benefit. I understand that state law requires me to provide proof that I am lawfully present in the United States when asked as well as submission of a secure and verifiable document. I may also be required to provide proof of lawful

presence. I further acknowledge that making a false, fictitious, or fraudulent statement or representation in this sworn affidavit is punishable under the criminal laws of Colorado as perjury in the second degree under Colorado Revised Statute 18-8-503 and it shall constitute a separate criminal offense each time a public benefit is fraudulently received.

By signing this form, I certify that I purchased and/or recycled the lawn care equipment or service as stated above at the address indicated on the sales receipt.

Printed Name ________________________________________

Signature ___________________________________________

Date _______________________________________________

STEP 1 Complete and sign affidavit.

STEP 2 Complete rebate form and attach receipt.

STEP 3 Obtain stamp on recycling rebate voucher if recycling a gas powered lawn mower (on back).

STEP 4 Place completed form in envelope and mail to:

2019 Lawn & Garden Equipment Rebate Program Environmental Services PO Box 580 Fort Collins CO 80522-0580

FOR MORE INFORMATION 970-221-6600 or fcgov.com/lawnmowerRebates are issued on a first-come, first-served basis until funds are depleted. Other restrictions apply. Auxiliary aids and services are available for persons with disabilities. V/TDD: 711

Rules and Instructions1. Rebates available to Fort Collins residents only. One

rebate application per resident per year.

2. Rebates apply to qualifying equipment with a purchase price of $99 each or more.

3. Qualifying equipment includes electric or reel lawn mowers, electric or battery-powered string trimmers, hedge trimmers, edgers, chain saws, pole saws, cultivators, and tillers.

4. Recycling rebate is available ONLY for gas-powered lawn mowers.

5. Rebates are limited to $50 maximum per applicant

6. Purchases must be made during the rebate period (May 1 through July 31) and the rebate form must be received by August 2, 2019 to qualify.

7. Online purchases are not eligible.

YOU MUST BE A FORT COLLINS RESIDENT TO APPLY. ONE REBATE APPLICATION PER RESIDENT PER YEAR.

Att

ach

purc

hase

rece

ipt h

ere.

Lawnmower Recycling Rebate Voucher

Participating Retailers and Services

This form certifies that the following individual has recycled the following gas-powered lawn mower.

Name __________________________ Phone _________________________

Address _________________________________________________________

Make/model of equipment recycled ___________________________________

Received at ___________________ Received by ____________________ (store/location) (employee signature)

Date ___________________________________________________________

Please drain and properly dispose of oil and gas from old lawnmower before recycling. (See instructions at fcgov.com/lawnmower.)

Official stamp from recycling facility.

RETAILERSAce Hardware (Downtown)Ace Hardware (Harmony)Best RentalHome Depot (North)Home Depot (South)Lowe’s

215 S. College Ave.1001 E. Harmony Rd.1540 Riverside Ave.1251 E. Magnolia St.4502 JFK Pkwy.4227 Corbett Dr.

970-224-4437970-223-9273970-282-0700970-224-1239970-206-0774970-232-7910

LAWN CAREClean Air Lawn Care theron@cleanairlawncare.com 970-402-9256 RECYCLINGColorado Iron and Metal

Timberline Recycling Center,Hard-to-Recycle Materials Yard

903 Buckingham St.

1903 S. Timberline Rd.

970-482-7707

970-221-6600

2019

RE

CE

IVE

UP

TO $

50 IN

RE

BA

TE

S.

ON

LINE

PU

RC

HA

SE

S NO

T ELIG

IBLE

.

Rebate towards “clean” lawn and garden equipm

ent with a purchase price of $99 each or m

ore

Rebate toward one season of sustainable lawn care services

Rebate for recycling a gas lawn m

ower

CH

OO

SE

UP

TO

TW

O O

F T

HE

TH

RE

E O

PT

ION

S:

For more information

970-221-6600 fcgov.com/lawnm

ower