Water Heater Rebate Form

Applicant Information

Enter your Account #

First Name

Last Name

Email

Phone

Record Type Name

Service Address Information

Street

City

State Abbreviation

Please select... AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Zip Code

Equipment Info

Manufacturer

Model Number

Equipment Type

Please select... 50-74 gallon water heater (uniform energy factor .9+) Residential 75+ (uniform energy factor .88+ and must be on load control) Commercial 75+ (must be on load control) Heat pump water heater (uniform energy factor 2.2+)

Appliance Types

AppType

Attach Invoice Here

Terms and Conditions

• New equipment must be on cooperative lines. 

• New equipment must be electric.
• Incentive not to exceed the equipment cost. 
• Incentives are in place until December 31. Funds are limited.
• Required documentation must be submitted within 3 months of purchase. 
• Additional eligibility criteria may apply. Program is subject to change or cancellation without notice. Contact cooperative for details.  

Accept Terms and Conditions