Renew your wallet.

Going solar has never been so simple and affordable. Send us this quick form today to see if you qualify.

Proposal Request

Optimal Solution

Solar Own
Third Party Ownership
Lease
Power Purchase Agreement

Homeowner Information

First Name
Last Name
Phone
Email
Address of Installation Location
City
State
Zip Code

Co-owner (if any)

First Name
Last Name
Phone
Email

Utility Usage

Average Electricity Bill
Meter Number
Utility Account Number

Electric Usage kWh

Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec

Electric Usage $

Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec

Additional Information

Main Panel Rating
Main Breaker Size
Roof Pitch
Roof Type
Care or Medical Discount YesNo
Credit Score 680+ YesNo
Do you have an electric car? YesNo

I understand the terms and conditions of the Origin Renewables offer and grant full access to my electrical utility information to ensure the optimal System size and design for my location. I authorize Origin Renewables to obtain my credit information to verify ownership of the property listed above. I further agree to allow roof access to provide the exact roof section measurements, inspect roof condition and structure, verify type, azimuth, pitch, and penetrations. The surveyor will also inspect the main electrical panel and perform the necessary steps to qualify my property. I also agree to be contacted via phone, email or text message. I understand the price provided in this agreement to be an estimate. Actual price will be set forth in Final Agreement.

Signature (Please enter your full name)
Date

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