Energy Savings Rebate (ESR) program: Application for Ontario

To complete and submit your application, please use the fillable version of the Application form. The HTML version is available below for your reference.

Environment and Climate Change Canada must receive complete applications by email at ec.re-esr.ec@canada.ca no later than:

15:00 (3:00 p.m.), Eastern Daylight Time, on Tuesday, March 31, 2020*
For applicants with locations in at least one (1) and no more than four (4) single or upper tier municipalities in Ontario

Note that the deadline for retailers with locations in five (5) or more single or upper tier municipalities in Ontario closed on July 24, 2019. Results are expected to be communicated to applicants in August 2019.

* This portion of the funding will be provided on a first-come, first-serve basis, a notification will be added to the program website if this funding is exhausted in advance of the deadline.

Before completing this ESR application, the applicant should refer to the ESR Applicant Guide, available at the program website or upon request to ec.re-esr.ec@canada.ca.

Note: All sections of the application are mandatory. Any information found to be incomplete may result in the rejection of the application.

SECTION A – APPLICANT INFORMATION
Full legal name of applicant (i.e., corporation and/or trade name) Business Registration Number (9 digits)
Operational name of applicant business (if different than legal name)
Unit Number Street Number Street Name
City Province/Territory Postal code (A1A 1A1)
SECTION B – PRIMARY CONTACT INFORMATION
Full Name (Given Name and Surname)
Title
Telephone number (999-999-9999) Email
SECTION C – ELIGIBILITY
Please refer to the eligibility criteria outlined in the Applicant Guide.
☐ Select if the applicant is a retail company incorporated in Canada.

Applicant organizations must have a brick and mortar presence in at least one (1) single or upper tier municipality in Ontario. In Annex A, include a list of each location per single or upper tier municipality in Ontario where eligible products will be offered. Select if the applicant organization has:

☐ locations in at least one (1) and no more than four (4) municipalities. ☐ locations in five (5) or more municipalities.

To be eligible, applicants must carry for sale and intend to provide incentives for at least four (4) of the following eligible product categories. If applicants intend to provide rebates for an eligible product category, indicate the anticipated rebate level (no more than 25% of the purchase price and no more than $500 per item. There is an exception for 1) tankless condensing water heaters and 2) ductless mini split indoor units (air source heat pumps) where rebates will be no more than 25% of the purchase price and no more than $1,000 per item, not including taxes, warranties, installation or shipping).

Eligible Product Category

Anticipated Rebate Level (%)

☐ ENERGY STAR certified washer  
☐ ENERGY STAR certified dryer  
☐ ENERGY STAR certified washer/dryer combo  
☐ ENERGY STAR certified dishwasher  
☐ ENERGY STAR certified tankless condensing water heater  
☐ ENERGY STAR certified air purifier/room air cleaner  
☐ ENERGY STAR certified smart thermostat  
☐ ENERGY STAR certified ductless mini split indoor unit (air source heat pump)  
☐ ENERGY STAR certified room air conditioners  
☐ ENERGY STAR certified ceiling fans  
☐ ENERGY STAR certified dehumidifiers  
☐ CEE Tier 3 certified refrigerators and refrigerator-freezers  
☐ Electric vehicle home chargers  
☐ Induction stove tops  
SECTION D – Description of Rebates  
Provide a description of the planned rebates, including detail on the availability and/or applicability of online sales.  
SECTION E – Rebate Plan and Budget  
Provide details on the product categories available for rebates per time period, corresponding request for funding, and associated assumptions. Rebates can be provided as of the date of the signature of the funding agreement and up to September 30, 2020 for applicants with locations in five (5) or more municipalities and up to March 31, 2021 for applicants with locations in at least one (1) and no more than four (4) municipalities.
Time period Description of the eligible product categories available Requested funding for rebates Assumptions
As of the date of the signing of funding agreement to September 30, 2019      
October 1, 2019 to December 31, 2019      
January 1, 2020 to March 31, 2020      
April 1, 2020 to June 30, 2020      
July 1, 2020 to September 30, 2020      
October 1, 2020 to December 31, 2020 (if applicable)      
January 1, 2021 to March 31, 2021 (if applicable)      
SECTION F – FUNDING AMOUNT
Total requested funding reflects the information provided in Section E Rebate Plan and Budget.
Total Requested Funding ($)
SECTION G – SUBMITTING THE APPLICATION
☐ I hereby declare that the information contained herein is true, accurate and complete in every respect and contains no misrepresentations, falsifications, omissions, or concealment of facts.

Completed applications must be sent electronically to ec.esr-re.ec@canada.ca.

Personal information collected by Environment and Climate Change Canada (ECCC) is protected from disclosure to unauthorized persons/agencies pursuant to the provisions of the Privacy Act.

Questions or comments regarding this privacy notice or the administration of the Privacy Act at ECCC may be directed to the Access to Information and Privacy Coordinator at ec.aiprp-atip.ec@canada.ca.

If you are not satisfied that we have adequately respected your privacy, you may wish to contact the Office of the Privacy Commissioner by calling their information centre at 1-800-282-1376 or by visiting their contact page.

ANNEX A – LIST OF LOCATIONS IN ONTARIO
Total number of locations in Ontario  
Include a list of all stores in Ontario where eligible products may be offered and indicate the corresponding single or upper tier municipality. If the number of locations exceeds the number of lines provided in this Annex, provide supplementary documentation that continues this list. If you have more than one (1) location in a single or upper tier municipality, please list all relevant store names as separate entries.
# Store Name Unit Number Street Number Street Name City Postal Code (A1A1A1) Single or Upper Tier Municipality
1              
2              
3              
4              
5              
6              
7              
8              
9              
10              
11              
12              
13              
14              
15              
16              
17              
18              
19              
20              
21              
22              
23              
24              
25              
26              
27              
28              
29              
30              
31              
32              
33              
34              
35              
36              
37              
38              
39              
40              
41              
42              
43              
44              
45              
46              
47              
48              
49              
50              
51              
52              
53              
54              
55              
56              
Report a problem or mistake on this page
Please select all that apply:

Thank you for your help!

You will not receive a reply. For enquiries, contact us.

Date modified: