ENERGY STAR Residential Heat Pump Rebate Energy Star Certified Residential Heat Pump Rebate Customer InformationName * Required First Last Address * Required Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Do you have a different mailing address? * RequiredYesNoAddress Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone * RequiredEmail * Required How did you first learn about the heat pump rebates?Advertisement inserted in my billButton up WorkshopContractorEmailFriend/ColleagueInternet search (Google, Bing, Yahoo)NHEC WebsiteNHSavesNewsletterNewspaperPostal mailSocial mediaSelect oneTelephone Town HallOtherElectric Account Number * Requiredwhere equipment was installedExisting heating system fuel type * Required Oil Propane Electric Other New Construction Is the heat pump replacing existing air conditioning units * RequiredYesNoCapacity of the AC system being replaced * Requiredin BtU'sContractor InformationBusiness name * RequiredPhone * RequiredAddress * Required Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Fax NumberEmail Equipment InformationOnly ENERGY STAR® Certified heat pumps and heat pump water heaters meeting the minimum efficiency ratings outlined in the incentives table will be eligible for a rebate. EnergyStar Heat Pump/Mini Split SystemsPlease select your heat pump type Energy Star Certified Central/Hybrid Air Source Heat Pump Geothermal Energy Star Certified Ductless Mini-Split (heat pump) Manufacturer/Brand * RequiredOutdoor model number * RequiredIndoor model number * RequiredTotal Cost * RequiredRebate $ * RequiredInstall date - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY AHRI Ref# * RequiredSEER * RequiredEER * RequiredHSPF * RequiredGeothermal COPHeating ControlsEquipment WI-FI Thermostat (for Heat Pumps Only)** **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 for a rebate.Install date - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY Manufacturer/BrandModel numberQuantityTotal costRebate $Please attach copies of dated invoices with equipment make and model specifications. * Required Drop files here or Accepted file types: pdf, doc, docx, jpg, png, xls, xlsx. Sign HereDownload Eligible Equipment & Incentives, and read Terms and ConditionsI have read and understand the terms and conditions. I certify that the information I have provided is true and correct and the products(s) and equipment for which I am requesting an incentive meets the requirements in this application. * Required Yes Customer Digital Signature * RequiredDate - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY Untitled Energy Star Certified Residential Heat Pump Rebate Customer InformationName * Required First Last Address * Required Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Do you have a different mailing address? * RequiredYesNoAddress Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone * RequiredEmail * Required How did you first learn about the heat pump rebates?Advertisement inserted in my billButton up WorkshopContractorEmailFriend/ColleagueInternet search (Google, Bing, Yahoo)NHEC WebsiteNHSavesNewsletterNewspaperPostal mailSocial mediaSelect oneTelephone Town HallOtherElectric Account Number * Requiredwhere equipment was installedExisting heating system fuel type * Required Oil Propane Electric Other New Construction Is the heat pump replacing existing air conditioning units * RequiredYesNoCapacity of the AC system being replaced * Requiredin BtU'sContractor InformationBusiness name * RequiredPhone * RequiredAddress * Required Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Fax NumberEmail Equipment InformationOnly ENERGY STAR® Certified heat pumps and heat pump water heaters meeting the minimum efficiency ratings outlined in the incentives table will be eligible for a rebate. EnergyStar Heat Pump/Mini Split SystemsPlease select your heat pump type Energy Star Certified Central/Hybrid Air Source Heat Pump Geothermal Energy Star Certified Ductless Mini-Split (heat pump) Manufacturer/Brand * RequiredOutdoor model number * RequiredIndoor model number * RequiredTotal Cost * RequiredRebate $ * RequiredInstall date - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY AHRI Ref# * RequiredSEER * RequiredEER * RequiredHSPF * RequiredGeothermal COPHeating ControlsEquipment WI-FI Thermostat (for Heat Pumps Only)** **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 for a rebate.Install date - must be mm/dd/yyyy format Date Format: MM slash DD slash YYYY Manufacturer/BrandModel numberQuantityTotal costRebate $Please attach copies of dated invoices with equipment make and model specifications. * Required Drop files here or Accepted file types: pdf, doc, docx, jpg, png, xls, xlsx. Sign HereDownload Eligible Equipment & Incentives, and read Terms and ConditionsI have read and understand the terms and conditions. I certify that the information I have provided is true and correct and the products(s) and equipment for which I am requesting an incentive meets the requirements in this application. * Required Yes Customer Digital Signature * RequiredDate - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY Untitled