2023 Residential Heat Pump Online Rebate Application

Member Information

Name*

First Last

Installation Address*

Street Address Address Line 2 City State ZIP Code

Do you have a different mailing address?*

Yes
No

Mailing Address

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Electric Account Number*

where equipment was installed

How did you first learn about the heat pump rebates?

Existing heating fuel type*

Oil
Propane
Electric
Other
New Construction

Existing heating system type*

Furnace
Boiler
Heat Pump
Other
New Construction

Is the heat pump replacing existing air conditioning units*

Capacity of the AC system being replaced*

in BtU's

Contractor Information

Business name*

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Fax Number

Email

Equipment Information

Only ENERGY STAR® Certified heat pumps meeting the minimum efficiency ratings outlined in the incentives table will be eligible for a rebate.

EnergyStar Heat Pump/Mini Split Systems

Please select your heat pump type

Air Source Heat Pump
A/C Only Heat Pump
Geothermal Heat Pump

Install date*

Quantity*

AHRI Ref#*

AHRI Cooling Capacity*

Number of Tons (1 Ton = 12,000/BTU/h)*

Manufacturer/Brand*

Outdoor Model Number*

Total Cost*

Rebate Amount*

SEER*

EER*

HSPF*

Geothermal COP

Heating Controls

Equipment

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, 2023 – December 31, 2023 to be eligible for a rebate.

Install date

Quantity

Manufacturer/Brand

Model Number

Total Cost

Rebate Amount

For new Heat Pump and Geothermal systems that offset 80% of the home's total heating load, there is an additional $250 per ton incentive available. Submit with your application: 2 years of heating fuel usage, Type of fuel, Existing heating system equipment efficiency %. Are you applying for the 80% bonus incentive?*

For homes that have participated in the Home Performance w/ ENERGY STAR program in the last 12 months there is an additional $250 per ton incentive available. Are you applying for the Home Performance w/ ENERGY STAR bonus incentive?*

Are you applying for third party financing?*

Please attach copies of dated invoices with equipment make and model specifications.*

Drop files here or

Accepted file types: pdf, doc, docx, jpg, png, xls, xlsx, Max. file size: 1 GB.

Sign Here

Download Eligible Equipment & Incentives, and read Terms and Conditions

I 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.*

Yes

Customer Digital Signature*

Date*

2023 Residential Heat Pump Online Rebate Application

ENERGY STAR Certified Heat Pump Rebate

Member Information

Contractor Information

Equipment Information

EnergyStar Heat Pump/Mini Split Systems

Heating Controls

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