This section contains the forms used in both the Home Performance with ENERGY STAR and EmPower New York Programs to be used by Participating Contractors.  This section will evolve over time, as NYSERDA works to more fully integrate the administration of these two programs and align program processes, procedures, and forms.

Forms that customers complete are located in Section 3 – Customer Participation.

8.1 | Home Performance with ENERGY STAR (including Assisted):

8.1a | ‘So What’s Next Brochure’ → rev. 04.2017

8.1b | Sample Eligibility Summary Report → rev. 07.24.2016

8.1c | Customer Information Form → rev. 06.2015

     * Fillable Customer Information Form * → rev. 06.2015

8.1d | Field Change Order Form → rev. 09.2015

8.1e | Certificate of Completion → rev. 11.29.2021

8.1f | State Historic Preservation Office Form → rev. 09.13.2016

8.2 | EmPower New York:

        8.2a | EmPower Request for Contractor Forms → rev. 12.07.2017

8.2b | EmPower Initial Interview Form → rev. 07.01.2014

8.2c | EmPower Certificate of Completion → rev. 11.29.2021

8.2d | EmPower Combustion Appliance Form → rev. 09.01.2016

8.2e | EmPower Appliance Exchange Agreement → rev. 07.15.2019

            * Fillable EmPower Appliance Exchange Agreement Form * → rev. 07.15.2019

8.2f | EmPower Notification of Possible Presence of Asbestos → rev. 09.01.2016

8.2g | EmPower Clean & Tune Checklist & Certification → rev. 08.2009

8.2h | EmPower House Diagram Worksheet → rev. 09.01.2016

8.2i | Empower Optional Field Data → rev. 09.01.2016

8.2j | EmPower Supplemental Data Collection → rev. 09.01.2016

8.2k | EmPower NY Opt Out  → rev. 08.17.2021