ENERGY STAR Certified Residential Water Heater Rebate

Member Information

Electric Account Number *

Where equipment was installed

Name *

First Last

Address *

Street Address Address Line 2 City State ZIP Code

Is this the customer's mailing address? *

Yes
No

Mailing Address *

Street Address Address Line 2 City State ZIP Code

Phone *

Email *

How did you hear about this rebate?

Existing domestic water heating system fuel type *

Oil
Propane
Electric
Other
New Construction

Section Break

Contractor Information

Contractor Name *

Phone *

Company Address *

Street Address Address Line 2 City State ZIP Code

Fax

Email

ENERGY STAR Certified Water Heater

Heat Pump Hot Water Heater Model Number *

Heat Pump Water Heater Size (Gallons) *

Heat Pump Water Heater Efficiency (>2.3) *

Install Date *

Quantity *

Rebate *

Total Cost *

Heating Controls

Wi-Fi Thermostat (for Heat Pumps Only)

Yes

* Wi-Fi Connections must be enabled. Rebate not to exceed purchase price. Limit one (1) thermostat per heat pump zone installed per account. Qualifying equipment must be installed between January 1, 2019-December 31, 2019 to be eligible.

Manufacturer/Brand

Model Number

Quantity

Rebate

Please attach copies of dated invoices with equipment specifications *

Drop files here or

Verify & Sign

Only ENERGY STAR® Certified heat pumps and heat pump water heaters meeting the minimum efficiency ratings outlined in the incentive will be eligible for a rebate.

Download Eligible Equipment & Incentives, and read Terms and Conditions

I understand the Terms and Conditions *

Yes

I have read and understand the terms and conditions of this application. I certify that the information I have provided is true and correct and the product(s) and equipment for which I am requesting an incentive meets the requirements of this application