Medical Declaration Form

Step 1 of 2

50%
  • Self Declaration Form for Relief from the OCEB Limit

    Written Notice Regarding the Use of Medical Equipment Under Section 3.2 of the Ontario Clean Energy Benefit Act, 2010

  • The Ontario Clean Energy Benefit (OCEB) provides eligible customers a 10 per cent rebate on the total cost of electricity charges related to electricity consumption on their bills including HST. This rebate will be in effect for five years until December 31, 2015. Effective September 1, 2012, the rebate for eligible customers will be limited to the first 3,000 kWh per month of consumption. However, there is an exemption from this limit for households in which persons who require medical equipment reside under the following circumstances:
    1. A person who resides in the premises to which the eligible account relates uses medical equipment which requires electricity for its operation.
    2. The medical equipment referred to in above was prescribed by a health practitioner who is a member in good standing of a health profession who is listed in Schedule 1 to the Regulated Health Professions Act, 1991.
    3. The cost or a portion of the cost, of the electricity used for the operation of the medical equipment is included in the calculation of the base invoice amount for the consumer’s eligible account.
    4. The consumer gives the written notice described in Section 3.2(4) of the Ontario Clean Energy Benefit Act, 2010 to the electricity vendor for the eligible account before July 1, 2016.
    5. In order for us to determine your eligibility for an exemption from the maximum financial benefit and accurately calculate your bill, please complete and return this Form as soon as possible.
    6. Account Information