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NYSERDA

Clean Energy Partners Payment Request Form

Thank you for participating in the Cooperative Advertising and Training for Clean Energy Partners program. 

The Payment Reimbursement Form provides NYSERDA with proof of completion of the pre-approved cooperative advertising and/or training activity. 

You will not be able to save partially completed payment request forms. Be sure to have all the required information (refer to the Program Manual) with you before starting this application. You will receive a tracking number and confirmation on your screen to print or save after you have submitted the form. Refer to this tracking number to check on the status of your payment request.

If you have any questions, please reach out to coop@nyserda.ny.gov.

Please note: Partially completed information cannot be saved, be sure to have all details with you before beginning the form. For the best form completion experience, use the Google Chrome browser.

* Required field

Date advertising first appeared in market

Date Picker

Date advertising last appeared in market

Date Picker

Final Cost of Co-op Activity

Backup Documentation

Upload third-party invoice/bill that shows the cost of the activity

Click Here to Upload

Upload final advertisement (as it was displayed or printed) or course curriculum/outline

Click Here to Upload

Upload other related documents

Click Here to Upload

The Participant agrees that by the act of submitting this Payment Request Form, the Participant confirms and agrees to abide the program terms and conditions, the applicable Manual, and with all accepted industry standards, and best practices. This Agreement does not obligate NYSERDA to make any payment to the Participant.

Authorized Signatory

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Co-op Payment Request Tracking Number

You will be provided with a Co-op Payment Request Tracking Number upon submission.