Borrower Request Form – PPL Electric Utilities

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Record Type*

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Referrer

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Program

Record ID

What Equipment are you Purchasing?

Did the project receive Pre-Approval from the Program Implementer?*

EA Number or Work Order Number*

Pre-Approval Document from the Rebate Program Implementer*

Max. file size: 128 MB.

e.g., offer letter, notice to proceed, pre-qualification letter

Contractor Final Quote/Invoice*

Max. file size: 128 MB.

To qualify for Exclusive OPTIMUS Financing program, your project must be first Pre-Approved by PPL Electric Business Energy Efficiency Program. If your project has not received a pre-approval, please visit: https://www.pplelectricbusinesssavings.com for more information. You can also submit your contact information, and we will follow up with you.

Contact First Name*

Contact Last Name*

Contact Phone*

Contact Email*

Improvement Type*

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Where are you purchasing the equipment from name of contractor?*

Please Provide the Contractor Business Name*

Please Provide the Contractor Email*

Please Provide the Contractor Phone*

Financing Amount*

Preferred Financing Term*

For more information please contact 844-655-9364 or email us at eefinancing@egia.org.

Where is the Equipment Being Installed?

Company*

DBA Name

HQ Address*

HQ City*

HQ State*

HQ Zip*

Equipment Address, City, State, Zip*

Equipment Install City*

Equipment Install State*

Equipment Install Zip*

Years In Business*

Rent or Own this Location?*

Local HQ Phone

Tax ID*

# of Employees

Company Ownership

Owner 1 First Name

Owner 1 Last Name

Owner 1 % of Ownership

Please enter a number from 0 to 100.

Owner 1 Email

Owner 1 Cell Phone

Owner 1 SSN

Social Security Number will be used to verify company ownership

Owner 2 First Name

Owner 2 Last Name

Owner 2 % of Ownership

Please enter a number from 0 to 100.

Owner 2 Email

Owner 2 Cell Phone

Owner 2 SSN

Social Security Number will be used to verify company ownership

Add Another Owner?

Owner 3 First Name

Owner 3 Last Name

Owner 3 % of Ownership

Please enter a number from 0 to 100.

Owner 3 Email

Owner 3 Cell Phone

Owner 3 SSN

Social Security Number will be used to verify company ownership

Project Financing Calculator