Energy Saver North Carolina
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Homeowner Attestation of Completed Energy Improvement Work
Homeowner Name
Property Address
Phone Number
Email
Project Details
Please briefly describe the energy improvement(s) completed (e.g., insulation upgrade, HVAC replacement, air sealing)
Contractor Name
Date of Completion
*
Please enter a valid date in MM/DD/YYYY format
Attestation Statement
I, the undersigned homeowner, affirm that the energy efficiency improvement(s) listed above have been completed at the above-referenced property to the best of my knowledge. I understand that this information may be used for program verification and reporting purposes. I also agree to allow representatives of the program or its partners to contact me for additional information or to schedule a quality assurance inspection, if necessary.
I acknowledge that the work was completed to my satisfaction.
I grant permission for follow-up contact or inspection, if needed.
Homeowner Signature
*
Clear
Please sign here to confirm your acknowledgment.
Date of Signature
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