Current Open Forms

2. Town of Erie Turf Replacement Rebate Application

   Print a copy of this application for your records.

4. First Name
5. Last Name
7. Address1
9. Address2
11. City
12. State
13. Zip
15. Water Utility Account Number
16. Email Address
18. Phone Number
19. Final Project Area (Minimum of 200 Sqft)
21. Receipts

    Upload receipts here

22. Upload More Receipts Here
23. Upload More Receipts Here
25. Affadavit

    I swear or affirm under penalty of perjury under the laws of the State of Colorado that (check one): I am a United States citizen and/or I 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 acknowledge 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 the fixtures or appliances as stated above and plan to install it (them) at the address indicated above within the Town of Erie service area.

27. Electronic Signature
28. Date
    Date

    Date
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit Submit and Print

* indicates a required field