2016 Lawn & Garden Equipment Rebate
Rules and Instructions
1. Rebates are available to Fort Collins residents only.
2. Rebates apply to qualifying equipment with a purchase
price of $99 or more.
3. Qualifying equipment includes electric or reel
lawnmowers; 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
lawnmowers with the purchase of an electric or reel
mower
5. Rebates are limited to $50 maximum per applicant
6. Purchases must be made between May 1 and
July 31, 2016 and this form must be received by
August 5, 2016 to qualify
STEP 1: Complete and sign Affidavit
STEP 2: Complete Rebate Form and attach participating store
receipt or copy of receipt to verify purchase.
STEP 3: Complete Survey (on back)
STEP 4: Obtain stamp from Recycler if recycling a gas powered
lawnmower (on back)
STEP 5: Place completed form in envelope and mail to or drop
off at:
2016 Lawn and Garden Equipment Rebate Program
Environmental Services - 1st Floor
215 N. Mason St.
P.O. Box 580
Fort Collins CO 80522-0580
for more information (970) 221-6600 - fcgov.com/airquality/rebate.php
Rebate Form
You must be a Fort Collins resident to apply
Name________________________________________
$25 Rebate for full season of “clean” lawn care service.
Mailing Address ________________________________
Phone ________________________________________
Indicate the rebate you are applying for:
$25 Rebate for purchase of other qualifying “clean” (electric
or battery powered) lawn and garden equipment
(please specify type of equipment)
Electric Leaf Blower
$25 Rebate for purchase of “clean” lawnmower - (electric or
push-reel mower)
$25 Rebate for recycling gas lawnmower with purchase of clean
mower. (gas mower must be properly drained of oil and gas
before recycling)
Electric Hedge Trimmer
Electric Chain/Pole Saw
Electric String Trimmer
Electric Edger
Electric Cultivator/Tiller
Affidavit
Restrictions on Public Benefits
Pursuant 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):
q I am a United States Citizen
q 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 acknowledg 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
Date _____________________
______________________________
Signature
Survey
1. Are you replacing an existing piece of equipment or adding a new piece of equipment to your tool set?
(For example: I am replacing an old gas chain saw with a new electric pole saw) ___________________________________________________________________
2. If replacing a piece of equipment: what is the make, model, and age of the old equipment? _______________________________
3. On average, how many times per month and for how long will you use the new piece of equipment? (For example: I mow twice
per month for about 45 minutes each time)_______________________________________________________________________
4. Does your neighborhood/family/social organization have a “tool sharing” program? Do you think the City should encourage tool
sharing programs?______________________________________________________________________________________________
5. Did this rebate program influence your decision to buy “clean” lawn and garden equipment?
__ 1
__2
not at all
__3
somewhat
__4
__5
very much
Lawnmower Recycling Rebate Voucher
This form certifies that the following individual has recycled the following gas-powered lawnmower
Name: ________________________________ Phone _______________________________________
Address______________________________________________________________________________
Official stamp from
recycling facility.
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.
2016
Lawn & Garden
Equipment Rebate
Program
$25 Rebate towards “clean” equipment with a
purchase price of $99 or more OR one year of
sustainable lawn care services*
May 1 to July 31, 2016
•
$25 Rebate for recycling a gas mower with
purchase of “clean” mower*
EARN UP TO $50 IN REBATES
•
Purchases must be made between
May 1 and July 31, 2016 from
participating retailers and rebate
forms must be received by
August 5, 2016 to qualify
*Rebates limited to $50 maximum per applicant