Name:

Unit/Apt:

Home Address:

City:

Zip Code:

Phone Number:

Customer EE Interest: Select an interest Bill Savings Summer Reliability Program Heat Pumps Appliance Rebates Other

What is the size of the home (square footage)?

How many occupants are there in the home?

What is the age of the home?

How long ago was your house insulated?

Are there any air leaks or drafts in the home? Yes No Unsure

What type of heating and cooling system is installed in the home? AC System Other

How old is the heating and cooling system?

Are there any programmable thermostats or smart home devices controlling the temperature? Yes No

What type of windows are installed in the home? Are they single-pane or double-pane? Double-pane Single-pane or outdated

Are there any energy-efficient appliances in the home (e.g., refrigerator, dishwasher, washing machine)? Yes No

Are there any LED light bulbs installed in the home? Yes No Unsure

What are the typical energy usage patterns (e.g., high usage during certain hours, specific appliances used frequently)?

Are there any energy-saving habits or practices followed by the occupants? Yes No

Are there any additional questions you have at this time?