Colorado Residential Renewable Programs Single-Family Residence Income Verification

Check this box if a solar installer is filling out this form on customer's behalf

Applicant Information

Applicant First Name

Applicant Last Name

Applicant Phone Number

Applicant Email

Solar Installer Company Name

Solar Installer Email

Xcel Energy Account Number

Applicant Installation Address

County

Mailing Address (if different from installation address)

Household Information

Is your household enrolled in any of the following programs?

Do you live in a disproportionately impacted community?

Household Member 1

First Name

Last Name

Relationship

Receive Income?

Household Member 2

First Name

Last Name

Relationship

Receive Income?

Household Member 3

First Name

Last Name

Relationship

Receive Income?

Household Member 4

First Name

Last Name

Relationship

Receive Income?

Household Member 5

First Name

Last Name

Relationship

Receive Income?

Household Member 6

First Name

Last Name

Relationship

Receive Income?

Household Member 7

First Name

Last Name

Relationship

Receive Income?

Household Member 8

First Name

Last Name

Relationship

Receive Income?

Upload Supporting Documents

Document 1

Document 2

Document 3

Document 4

Document 5

Document 6

Document 7

Document 8

Document 9

Document 10

By checking this box and submitting this application to receive income-qualified incentives when installing an onsite solar system, the individual submitting this form: (1) acknowledges that such individual is the account holder whose premises address appears above; (2) acknowledges and confirms the information in this application is accurate and complete; and (3) confirms that the account holder has read and understands the terms and conditions applicable to the Solar* Rewards Income-Qualified Program and agrees to be bound by such terms and conditions.

This program is sponsored by Xcel Energy^® and implemented by CLEAResult