IL Disclosure Form (Purchase)
Fill out required fields for the Illinois Disclosure Form
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Customer Full Name
*
Street Address
*
City
*
State
*
Please Select
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip
*
Phone Number
*
Email
*
example@example.com
(DC) System Size
*
For Example: 8.10
(AC) System Size
*
The AC system size is the SolarEdge model number in kilowatts (SE7600 = 7.60) (see chart below)
SolarEdge
Electric Utility
*
Please Select
AmerenIllinois
ComEd
MidAmerican
Mt._Carmel
Municipal_Utility
Rural_Electric_Cooperative
If you choose Rural Electric Cooperative or Municipal, please select the from the list below
*
Please Select
Adam Electric Coop
Cairo Public Utility Company
City of Albany
City of Allendale
City of Springfield
Corn Belt Energy Corporation
Eastern Illinois Elec Coop
Menard Electric Coop
Rural Electric Conven Coop
Shelby Electric Coop
Southern Illinois Elec Coop
Utility to send into Salesforce
System Purchase Price
*
Numbers Only (no symbols)
Est.Annual Production
*
Numbers Only (no symbols)
Production Explanation
*
System performance is based on a X.XX kW system with azimuths XX, XXX, XX, and XXX With some [XXX small shading from trees on the west XXX]. PV Watts Shading engine used.
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of
Estimated Full SREC Amount
*
Use calculator at: https://docs.google.com/spreadsheets/d/1t34VhI1YQSjWcHEIii2VcPdJhmoNPHRcdbYNWbKqdMQ/edit?usp=sharing
Estimated SREC Amount the Customer Receives
*
Estimated SREC Utility Collateral
*
System Mounting
*
Please Select
Roof
Ground
Install Type
Please Select
Roof Mount
Ground Mount
Battery Make and Model
*
Please Select
SolarEdge BAT-10K1P
No Battery
Number of Batteries
*
Please Select
0
1
2
3
Inverter Model
Annual Usage (kWh)
*
Rep Full Name
*
Rep Phone Number
*
IL Disclosure Place Holder
Submit
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