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Residents › Toilet Rebate › Rebate Application Form

High Efficiency Toilet Rebate Online Application Form

Contact Information

Name(Required)
Mailing Address(Required)

New Toilet Information

Toilet #1
Toilet #2
Skip if not applicable.
Toilet #3
Skip if not applicable.
Additional Information
High Efficiency Toilet installed by
Is the installation address the same as the mailing address above?(Required)
Installation Address

Submission Required Documentation

The following photos of pre- and post- installation of the water efficiency upgrades are required.
Drop files here or
Max. file size: 64 MB.
    Drop files here or
    Max. file size: 64 MB.
      Drop files here or
      Max. file size: 64 MB.
        Drop files here or
        Max. file size: 64 MB.
          Drop files here or
          Max. file size: 64 MB.
            Max. file size: 64 MB.

            Rebate Request

            Note: once this rebate application has been received and approved, a completed reimbursement form is required to receive payment. This form requires submitting your social security number or taxpayer identification number (TIN). The rebate will be a check mailed to the address approximately 6 – 8 weeks days after receives a complete application. Any questions regarding the taxability of the payment should be directed to your tax professional.

            Participant Questions

            Have you previously participated the ConserveKane Toilet Rebate Program?(Required)
            How would you describe your current level of familiarity with water conservation practices?(Required)

            Agreement to Terms

            Please read the full program terms and conditions prior to completing this section.
            Terms and Conditions(Required)
            Enter your full name to accept all the terms and conditions stated above.(Required)
            MM slash DD slash YYYY
            PCMO/jat 8/12/25
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            Address

            Kane County
            535 South Randall Road
            St. Charles, IL 60174-1591
            Phone: 630-584-6166
            Hours: Monday – Friday 8:30 am to 4:30 pm

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            Apply for a Rebate

            Water Conservation rebates are a financial incentive and the ConserveKane program is offering a low flow toilet rebate program to qualified residents.

            • Rebate Application
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