Please read the following instructions carefully to determine if you need to complete this self-declaration form for the Ontario Electricity Rebate (OER).

The following customers are automatically eligible for the OER and do not need to complete the self-declaration form:

• Residential and Small Commercial customers (billed under a Residential or General Service Energy rate class) using less than 50 kW.
• Commercial accounts that are greater than 50 kW but use less than 250,000 kWh annually.

The following customers are eligible for the OER but need to complete the self-declaration form to receive the rebate:

Commercial customers (billed under a General Service Demand) who: (1) have a demand for electricity greater than 50 kW, (2) use more than 250,000 kWh a year, and (3) fall under one of the following eligibility criteria:

• Farming Business
• Long-term care home, other than an account that is also in respect of a hospital
• Multi-unit complexes that are predominantly residential, such as condominium and apartment buildings
• Common elements in multi-unit complexes that are predominantly residential (as of July 1, 2022)
• Retirement residence (as of July 1, 2022)
• Mobile home park (as of July 1, 2022)

Definitions for the above terms are provided here.

Note: Some accounts that are not eligible but were receiving the former 8% Provincial Rebate that was in place before the OER was introduced on November 1, 2019 receive the OER under a legacy exemption.

Complete this form ONLY if your account relates to:

• A multi-unit complex
• Any common elements of a multi-unit complex
• A retirement residence
• A mobile home park

Important note regarding Regulated Price Plan (RPP) eligibility: If your account is using >50 kW and >250,000 kWh/year and is a Farming Business or a Multi-Unit Complex as defined below (does not apply to long-term care homes), you may also be eligible for Regulated Price Plan (“RPP”) pricing and can apply using the RPP Self-Declaration Form. Residential and Small Commercial customers using less than 50 kW and commercial accounts that are greater than 50 kW but use less than 250,000 kWh annually automatically qualify for RPP and do not need to apply.

Please refer to the next page of these instructions for a list of ineligible premises.

A multi-unit complex is ineligible for the Ontario Electricity Rebate if any part of it falls under one of the following categories:

• A hotel, motel, motor hotel, resort, lodge, tourist camp, cottage or cabin establishment, inn, campground, tourist home, bed and breakfast vacation establishment or vacation home
• A trailer park that is not a mobile home park
• Living accommodation occupied by a person for penal or correctional purposes
• A hospital
• A premises that is subject to the Ministry of Correctional Services Act or the Child, Youth and Family Services Act, 2017
• Short-term living accommodation provided as emergency shelter
• Living accommodation provided by an educational institution to its students or staff where:
  1. the living accommodation is provided primarily to persons under the age of majority, or all major questions related to the living accommodation are decided after consultation with a council or association representing the residents, and
  2. the living accommodation is not intended for year-round occupancy by full-time students or staff and members of their households.
• A university, college of applied arts and technology or other entity that provides post-secondary education
• Premises that is identified by a NAICS code commencing with the digits 21, 22, 23, 31, 32 or 33 (i.e. in the mining, quarrying, oil and gas extraction, utilities, construction and manufacturing sectors)

Please review this list carefully. If your multi-unit complex includes any of the above, it is ineligible for the OER.

To be eligible to receive the rebate, you must qualify under one of the following six criteria. Please choose the option that applies to your account:

General Confirmation

I confirm that my account does not relate in whole or in part to any of the following types of excluded premises:

• A hotel, motel, motor hotel, resort, lodge, tourist camp, cottage or cabin establishment, inn, campground, tourist home, bed and breakfast vacation establishment or vacation home
• A trailer park that is not a mobile home park
• Living accommodation occupied by a person for penal or correctional purposes
• A hospital
• A premises that is subject to the Ministry of Correctional Services Act or the Child, Youth and Family Services Act, 2017
• Short-term living accommodation provided as emergency shelter
• Living accommodation provided by an educational institution to its students or staff where:
  1. the living accommodation is provided primarily to persons under the age of majority, or all major questions related to the living accommodation are decided after consultation with a council or association representing the residents, and
  2. the living accommodation is not intended for year-round occupancy by full-time students or staff and members of their households.
• A university, college of applied arts and technology or other entity that provides post-secondary education
• Premises that is identified by a NAICS code commencing with the digits 21, 22, 23, 31, 32 or 33 (i.e. in the mining, quarrying, oil and gas extraction, utilities, construction and manufacturing sectors)

I consent to Renfrew Hydro disclosing the following information to the Ministry of Energy, Northern Development and Mines:

• the name of the Account Holder (unless the account is in the name of an individual);
• where applicable, the Farm Business Eligibility Criteria applicable to the Account; and
• where applicable, the total consumption of electricity for the period May 1, 2018 to April 30, 2019.