NCEF's Energy Audit Incentive Application

Energy Audit Incentive Application
Thank you for your interest in the Energy Audit Program! For detailed information about program guidelines and requirements, please visit our website https://nevadacef.org/audit/. Be sure to review the program guidance to ensure your application meets all criteria. If you have any questions, feel free to contact us for assistance at the email greenloans@nevadacef.org or call us at 775-689-9933
Household Point of Contact Name*

First NameLast Name
Are you a household, or an auditor filling out this form on behalf of a household?*

HouseholdAuditor
Auditor's Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Date of Birth*

MonthDayYear
Date
Property Information
Subject Property Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you live in the home receiving the audit?*

YesNo
Do you intend to live in the home for 5 or more years?*

YesNo
Is your home single or multi-family?*

Single-familyMulti-family
Are you the owner of the home?*

YesNo
Please upload proof of home ownership (mortgage statement, title, property tax statement, etc.)*

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If you do not own your home, have you obtained permission from your landlord or property owner to obtain an energy audit?*

YesNoNot Applicable
What is your primary source of income?*

Employment (Salary)Employment (Hourly)Self-employedRetirement/ Social SecurityVeteran's Benefits or DisabilityOther
What is your total approximate monthly income for your household?*
What is your household size?*
Have you found a licensed energy auditor to conduct your energy audit? (If not, NCEF can assist)*

YesNo
If yes, who is the auditor?
Did you receive a quote for the cost of the audit*

YesNo
Upload copy of quote

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Gender

FemaleMalePrefer not to answer
Hispanic origin

YesNoPrefer not to answer
Race/Ethnicity

American Indian or Native AmericanAlaska NativeNative HawaiianAsian American or Pacific IslanderBlack/African AmericanWhite/CaucasianPrefer not to answer
Marital Status

SingleMarriedSeparated/DivorceWidowedPrefer not to answer
Emergency Contact #1 Name*

First NameLast Name
Emergency Contact #1 Phone Number*

Area CodePhone Number
Please submit a copy of your most recent electric utility bill:*

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By applying for this program, you’ll be given a loan to cover the cost of an energy audit from a state licensed energy auditor. That loan will be forgiven in full when you purchase, finance, or receive assistance for an eligible home upgrade that was recommended by your auditor.
An individual 18 years or older must be present during the energy audit if a minor is also present
Have you read our program guidance document and do you understand key requirements of the incentive, such as providing utility bills (electric, gas, propane) to NCEF and making an effort to implement a measure suggested in the audit report?

YesNo
Please visit Nevadacef.org/audit for program guidance documents.
Please verify that you are human*
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