SOLAR HOT WATER STC ASSIGNMENT FORM Fax: 02 4868 1083 Email: renewableenergy@dux.com.au

CONTACT DETAILS First Name: Surname:

Installation Address:

Is there more than one system installed at this address?

If yes - Describe where this newly installed system is compared to existing unit/s at the address. (e.g. 2nd solar panel system installed on shed. First system installed on house)

Provide Details:

Is there any additional comments the CER should know in relation to this installation?

If yes - Provide Details

State: P/Code:

Owners Address:

State: P/Code:

Phone/Mobile: Email:

NEWLY INSTALLED SYSTEM DETAILS

Installation Date: Brand: Tank Serial Number:(12 Digits)

System Model No:

Tank Size: 160L 170L 180L 250L 315L 330L 400L Tank Warranty: 5 Years 10 Years7 Years

Airoheat

OR BOOSTER TYPE Electric Element 2.4KW 3.6KW 4.8KW OR Gas Type: Natural LPG

Collector Type: No. of Collectors: Booster Type: Off-Peak Continuous

REPLACED SYSTEM DETAILSInstalling in a New Building? Replacing an existing Electric Water Heater?

Replacing an existing Gas Water Heater? Replacing an existing Solar Water Heater?

Is the first installation of a water heater in an existing building?

Installer Name: Installer Phone:

Installer Address: State: P/Code:

CUSTOMER DECLARATION • I declare that the information herein is correct, and by signing this form. I assign the rights for this installation to create STCs for the above system to Dux

Manufacturing Limited.

• I am the owner of the solar water heater referred to in this form and have not assigned any STCs (or RECs) arising from its installation.

• I have read and understood the terms and conditions as listed over the page

Owner Signature: Date:

Terms and Conditions overleaf Dux Manufacturing Limited, PO Box 209, Moss Vale NSW 2577

Tank size of existing Solar Hot Water Heater?

Other (please specify)

Owner Name:

Witness Name: Date:Witness Signature:

WITNESS

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Eligible STCs:

Property Type: (please tick one) Residental School Commercial

No Yes

Single Storey Multi-StoreyAND: (please tick one)

No Yes

HEAT PUMP

GST DECLARATION I declare that (please tick appropriate response):

I am not registered for GST

I have issued to Dux Manufacturing Limited a valid tax invoice for GST purposes.

I have received a point of sale discount and therefore request payment of the STCs value be made to Dux Manufacturing.

Company Name:

SUPPPORTING DOCUMENTATION Must be sent in with the STC form

Plumbing Certificate of Compliance and Electrical Safety Certificate where applicable

Tax invoice or photographic evidence of the tank compliance plate

FOR OFFICE USE ONLY System STCs Total Value $ Invoice No: Authorised:

Fax: 02 4868 1083 Email: renewableenergy@dux.com.au

SOLAR HOT WATER STC ASSIGNMENT FORM

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BSB Number:

Account Name:

Fax Number:

ABN (Businesses only):

Email Address:

Payment Method –

Account Number:

All Payments will be made as direct deposit to your bank account. For payment confirmation, provide your fax or email. Please supply the following details:

Dux Manufacturing Limited , PO Box 209, Moss Vale NSW 2577

Send Completed Form To Fax (02) 4868 1083 Or Email: renewableenergy@dux.com.au

In order to calculate the number of certificates applicable and the certificate value, please contact Duxon 02 4868 0283. Further information regarding STCs can be viewed on http://www.cleanenergyregulator.gov.au/

*TERMS AND CONDITIONS

To be eligible for small-scale technology certificates, solar water heaters including air source heat pumps must: • be listed on the register of solar water heaters • be installed no more than 12 months prior to the creation of certificates, and • be classified as small-scale, and a: solar water heater with a capacity up to, and including 700 L (solar water heater models over 700 L capacity require additional documentation to be eligible for certificates), or air source heat pump with a capacity of no more than 425 L.

Make sure you retain all documents which relate to the installation for a period of five years, which may be requested by the Clean Energy Regulator.

1. Certificates may only be created once during the life of the installation and they must be created within 12 months of the installation date.

2. By signing this form, I assign the rights for this installation to create Small-scale Technology Certificates for the above system toDux Manufacturing Limited in exchange for:

a. Payment to be received by me which is equal to the value of the Small-scale Technology Certificates created from theinstallation of the solar hot water system, or

b. The discount that I received on the purchase of the solar hot water system which is equal to the value of the Small-scaleTechnology Certificates that will result from the installation of the solar hot water system.

3. Where I have received a discount on the purchase of the solar hot water system, I acknowledge that Dux Manufacturing Limited willpay an amount equal to the value of the Small-scale Technology Certificates that will result from the installation of the solar hot watersystem as I have indicated on the previous page.

4. I understand that I will not be able to sell or assign to anyone else my rights to these certificates and any other rights that may beassociated with the reduction of greenhouse gas emissions.

5. Where I am registered for GST, I understand that any payment made to me is inclusive of GST and is for the assignment of my rights.

6. I agree that I will not be entitled to any payment if my assignment is invalid or if Dux Manufacturing Limited cannot create or registerthe certificates. If payment has already been received by me, I agree to reimburse the full amount to Dux Manufacturing Limited.

7. I agree that the Clean Energy Regulator and/or Dux Manufacturing Limited or its appointed agent can inspect my system within thefirst five years of operation.

8. I have checked that the details on this form as well as the installation report are correct.

I understand that the information on this form will be made available to Dux Manufacturing Limited and Clean Energy Regulator andthe Australian Tax Office but will not be used for any other purpose but to create, check or audit Small-scale Technology Certificatesor to verify eligibility under the SWH Rebate Program.

I understand that there may be penalties applied for providing misleading information in this form under the Renewable Energy(Electricity) Act 2000.

9.

10.

From 17 August 2015 I will be required to provide, upon request, documentation to verify small-scale technology certificate creations in the REC Registry for solar water heaters and air source heat pumps.

11.