Water Conservation Division Rebate Request Form

Welcome to the City of Peoria
Water Conservation Pages

Conservation Rebate Program:
Rebate Application Request Form

Note: This submittal form is not the application. After completing this online request form, your account information will be verified, and an application will be sent to you through the mail. Please allow up to 10 business days for receipt of application.

* Fields are required

Rebate Type		Xeriscape Recirculator Irrigation Controller/Timer
Account Number	*	(located on your utility bill) Use format 000xxxxx-xx (ex:00012345-01) NOTE: You must enter the *correct* account number or your request will not be processed.
Name on Account	*
Applicant's First Name	*
Applicant's Last Name	*
Account Street Address	*
Account City	*
Account Zip Code	*

Is mailing address the same as property address?	*	Yes No If NO, YOU MUST fill out the following section.

Mailing Address
City
State
Zip Code

Email
Phone	*
Other Phone
Water Provider	*
Account Type	*
Property Type	*

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Publications	Groundwater Management Act of 1980	Free Classes	Xeriscape

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