Rhode Island Renewable Energy Growth Program

Rhode Island Renewable Energy Growth Program

Payment/Credit Transfer Form

RE Growth Small Solar Program Applicants must provide this form and required documentation, including IRS W-9 forms as indicated below,at the time of application for interconnection. All other RE Growth Applicants must provide this form and required documentation as a condition of initiating payments under the program.

Please mail this form and completed IRS W-9 forms to:

National Grid

40 Sylvan Road

2nd Floor East, E2.577

Waltham, MA 02451

Attn: RE Growth Applications

Applicant Information

RE Growth Applicant Name (legal name): enter text.

Street Address: enter text. City: enter text. State: enter text. ZIP: enter text.

Contact Name (if different from legal name): enter text. Telephone: enter text.

Email(s): enter text.

Facility Location (if different from above):

Street Address: enter text. City: enter text. State: Rhode Island ZIP: enter text.

Interconnection Application Number/Work Order (if available): enter text.

Host Facility National Grid Account Number (if available): enter text.

Payment Information

Payment of all Performance Based Incentives will be made out to and sent to the Applicant of Record under the legal name above. All Applicants must provide an IRS Form W-9 to National Grid per the National Grid RE Growth Tax Policy Statement. The Applicant Name and the Legal Name information on the W-9 must match. Payments will be remitted per instructions below:

Send Payment for Performance Based Incentives by: Check ☐ or Electronic Funds Transfer ☐

If by check, does Applicant want check sent to different address than above? Yes ☐No☐

If yes, please provide address below:

Location Name: enter text. Street Address: enter text.

City: enter text. State:enter text. ZIP: enter text.

Lock Box, Account Number or Other Note: enter text.

If by Electronic Funds Transfer, please complete the National Grid’s ACH Payment Authorization form.

Bill Credit Transfer Information

The RE Growth Residential Tariff requires that a residential customer who has installed a small scale solar system at their service location must use a portion of the Performance Based Incentive payment in the form of a bill credit to offset the electric service charges on the National Grid electric service account at the same location. For this purpose, a residential customer is defined as an electric customer receiving retail delivery service on either Basic Residential Rate A-16 or Low Income Rate A-60. All other RE Growth Applicants, at their option, may receive a portion of the Performance Based Incentive payment in the form of a bill credit to offset electric service charges of a National Grid electric service account, if that account is receiving retail delivery service at the same location as the Facility.

1. Is the Customer at the location of the Facility receiving electric service on Basic Residential Rate A-16 or Low Income Rate A-60?

Yes☐No☐

1. Is the Customer at the location of the Facility receiving electric service on a National Grid commercial electric service account (Rates C-06, G-02, G-32 or G-62), and does the Applicant choose to transfer bill credits to this customer account?

Yes ☐No☐

If yes to 1, bill credits are required to be transferred, but the recipient does not need to provide a W-9 and will not be issued Forms 1099 for bill credits.

If yes to 2, and the account holder is not the Applicant of Record, the Customer account holder must provide a Form W-9 to National Grid per the directions on the National Grid RE Growth Tax Policy Statement.

Payments will not be provided for output of the Facility until all required W-9 forms have been received.

Customer Name (on account): enter text.

National Grid Customer Account Number (10 digits): enter text.

Customer Legal Name (if different, on W-9):enter text.

Customer Account Three Year Average Billed Usage at Location (in kWh per year): enter text.

For internal use only

Applicant W-9 Confirmation: Yes __ No__

Non-Residential Customer Credit Transfer W-9 Confirmation: Yes __ No__

Applicant SAP Vendor ID:______

Customer SAP Vendor ID: ______

Applicant/Facility CSS Number (check) ______

Customer (Credit Transfer recipient) CSS Number (check) ______

Sizing Check (kWh) :Bill record______Output from Application:______

Date Processed: ______Employee: ______

Facility RE Growth Certificate of Eligibility Number: ______

Asset Identification Number (ISO-NE/NEPOOL GIS ID): ______