Promotion of Energy efficiency and renewable Sources of Energy In the domestic Sector Solar Water Heating Application Part 1 and Part II

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1 Promotion of Energy efficiency and renewable Sources of Energy In the domestic Sector Solar Water Heating Application Part 1 and Part II Malta Resources Authority Millennia Triq Aldo Moro Marsa, MRS 9065 MALTA Tel. : Fax.: enquiry@mra.org.mt Please ensure that you complete all sections of the form, including those overleaf. Applications that are not fully completed will not be processed. Faxes and photocopies of a completed application form are not acceptable. An application form has to be completed for each RES system purchased. Applicants must complete this form in conjunction with the installer and supplier of the proposed renewable generation system. The following parts should be completed: Parts I before purchase and installation Parts II before purchase and installation Part III after purchase and installation and after approval of grant. PART I to be filled in by the applicant before purchase and installation Section A Applicant Details Name: ID Card No: Surname: Telephone No: Section B Address where system is to be installed House name or number: Street: Locality: Post Code: Operational Programme I Cohesion Policy Investing in Competitiveness for a Better Quality of Life Project part-financed by the European Union European Regional Development Fund (ERDF) Co-financing rate: 85% EU Funds; 15% National Funds Investing in your future

2 Section C - Mailing address If you would like scheme correspondence to be mailed to a different address from the installation address given above, please complete this part. If not completed, all correspondence will be mailed to the address identified in Section B. House name or number: Street:_ Locality: Post code: Country: Section D (i) - Grant eligibility questions - Please tick boxes to confirm I confirm that I will obtain planning permission (where required) for this installation I confirm that I am the owner of the property or an emphyteuta or a tenant with all the necessary authority to apply for this grant I confirm that I (or any member of the household) have not obtained any other grants or subsidies for this system either from public or national funds or EU funds I confirm that the property where the system is installed is residential and is used by myself for residential purposes only I confirm that I am not applying on behalf of an undertaking (carrying out an economic activity) and am not a landlord of the property where the system is installed I am aware of Article 57 (Durability of Operations) of the Council Regulation EC/1083/2006 and shall abide by it I am aware that any publicity of technology installed would need to abide by EU funding publicity regulations I am aware that all the information submitted in this application may be cross checked with other government departments (ii) Additional Grant eligibility questions for solar water heating technology Please tick at least one box to confirm and fill in where appropriate:- I am in receipt of the energy voucher I am a Gozo resident My household annual gross income is and is less than Euro 16,070 I have purchased a residence to be used as a sole ordinary residence in terms of Chapt 364 section 32(4)(a) I am in receipt of the children s allowance and my annual gross income is less than Euro 23,923 I am in receipt of social assistance in accordance to the Social Security Act (Chapter 318 of the Laws of Malta)

3 Section E - Documents accompanying Part I of the application form: Please specify number of documents attached: iginal quotation containing seller and buyer details, segregated prices, description of product and date of purchase Photocopy of ID card Photo of the installation location, plus one photo taken from project location showing view to the south Complete electricity bill for the project location or evidence of site control required for new construction Any of the following documents: (please tick document attached) Recent social security statement related to social assistance or unemployment assistance -Energy Voucher Statement -FS3 statement or tax statement -Children s Allowance Statement -Contract for the purchase of a property under 120,000 as sole ordinary residence or declaration from a notary stating the price of the property purchased and that the residence is a sole ordinary residence Section G Applicant s Declaration I, the undersigned, certify that I have read and understood the requirements and conditions set for the grant available on the MRA website 1. The information provided in this form is accurate and true to the best of my knowledge. I understand that any attempt to misrepresent information in this application will invalidate this application and disqualify me from all claims to future rebates. I am aware that MRA auditors and other national and European authorities may perform on site inspections and that my name together with the investment aid granted may appear on public documents. Applicant Signature Date Section H Notes Data Protection: Personal information provided on this application (Parts I, II and III) is protected and used in accordance with the Data Protection Act. The information shown on this application form will be used and shared by/with the Malta Resources Authority and its agents, the Ministry for Finance, the VAT department and other Government entities and EU bodies involved in administering and supervising the scheme. The MRA may also use this information to demonstrate market transformation trends. In cases were the supplier does not conform to any provisions set out in the scheme, the supplier/installer shall be obliged to either change the equipment to bring the installations within the provisions of the scheme or pay the grant to the end consumer. This does not exclude the possibility that the end consumer may take legal action against the retailer to provide him with equipment as originally requested. You are advised to send your application by mail to: Malta Resources Authority Millennia, Aldo Moro Road, Marsa, MRS9065 Further information can be found on the MRA website: This application form may also be revised periodically. Please check the website to ensure that you have the latest version. 1 A copy of the scheme documents may be obtained from MRA offices

4 Promotion of Energy efficiency and renewable Sources of Energy In the domestic Sector Solar Water Heating Application Part 1 and Part II Malta Resources Authority Millennia Triq Aldo Moro Marsa, MRS 9065 MALTA Tel. : Fax.: enquiry@mra.org.mt PART II - Technical information to be filled in by the retailer of the equipment before purchase and installation Retailer details Name: Surname: Position: Address: address: Registration number: Technical details of installation Technology to be installed Solar Water heater (tick only one) Solar Collector For solar water heaters: Water Storage Capacity (litres): Collector size(m 2 ): Evacuated tube or flat plate: Equipment Model: Equipment Manufacturer: Quoted price: For Solar Collectors: Collector size(m 2 ): Evacuated tube or flat plate: Operational Programme I Cohesion Policy Investing in Competitiveness for a Better Quality of Life Project part-financed by the European Union European Regional Development Fund (ERDF) Co-financing rate: 85% EU Funds; 15% National Funds Investing in your future

5 Collector Model: Collector Manufacturer: Quoted price: Documents accompanying application form: Please specify number of documents attached: ORIGINAL quotation containing seller and buyer details, segregated prices, description of product and date of purchase Retailer s Declaration The information provided in this form is accurate and true to the best of my knowledge. I understand that any attempt to misrepresent information in this application will invalidate this application and disqualify me from all claims to future rebates. Retailer s Signature Date Name in block letters Retailer s Company Stamp: Note: Full technical literature to allow the MRA to assess the system is required, in accordance with the guidelines. There is the opportunity for retailers or installers to pre-register their products with the MRA to ensure that the system qualifies for the grant. Prospective applicants who intend to import systems directly are also urged to pre-register their systems themselves PRIOR to making any commitments. In cases were the supplier does not conform to any provisions set out in the scheme, the supplier/installer shall be obliged to either change the equipment to bring the installations within the provisions of the scheme or pay the grant to the end consumer. This does not exclude the possibility that the end consumer may take legal action against the retailer to provide him with equipment as originally requested.

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