Rebate Product Form
Applicant Information
Enter your Account #
First Name
Last Name
Email
Phone
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
Rebate Selection
Please select the Rebate you would like to apply for
Please select...
Recycled Refrigerator and/or Freezer
EnergyStar Clothes Dryer
Induction Cooktop (Measuring 30" or larger)
Smart Thermostat: Standard & Line-voltage (Quantity limits apply)
Whole House Fan (Not for powered attic ventilators)
Evaporative Cooler (Minimum 2,500 CFM)
Energy Star Heat Pump (Air Source) Water Heater
Additional Water Heater Incentives
Recycled Refrigerator and/or Freezer
Rebate Amount: $60
Appliance must be decommissioned for recycling and cannot be resold
Attach Receipt Here
How many appliances are you recycling?
Please select...
1
2
Application Record Type ID
EnergyStar Clothes Dryer
Rebate Amount: $30 or $90 with Hybrid heat pump dryer
Hybrid heat pump dryer?
Please select...
Yes
No
Manufacturer
Model #
Attach Receipt Here
Rebate Amount
Application Record Type ID
Induction Cooktop
(
Measuring 30" or larger)
Rebate
$100 for Electric-to-induction Replacements
$350 per unit for gas-to-induction replacement or new construction (must include picture of gas stove)
Manufacturer
Model #
Attach Receipt Here
Application Record Type ID
Smart Thermostat: Standard & Line-voltage
(Quantity limits apply)
Rebate Amount: $25 per thermostat
Smart Thermostat Type
Please select...
Standard
Line Voltage
Standard Quantity
Please select...
1
2
Line Voltage Quantity
Please select...
1
2
3
4
5
Manufacturer
Model #
Attach Receipt Here
Application Record Type ID
Whole House Fan
(Not for powered attic ventilators)
Rebate Amount: $100
Quantity
Please select...
1
2
Manufacturer
Model #
New Installation or Replacement?
Please select...
New Installation
Replacement
Primary or Secondary Cooling?
Please select...
Primary
Secondary
Attach Receipt Here
Application Record Type ID
Evaporator Cooler (
Minimum 2,500 CFM)
Rebate Amount: $200
Quantity
Please select...
1
2
Manufacturer
Model #
Attach Receipt Here
Application Record Type ID
EnergyStar Heat Pump Water Heater
Rebate Amount: $350
Application Record Type ID
Product Manufacturer
Product Model Number
Number of Gallons
Additional Water Heater Incentives
Incentives
Fuel Switching from Gas/Propane - $50
New Construction - $30
Manufacturer
Model #
Number of gallons
Attach Receipt Here
Application Record Type ID
reCAPTCHA helps prevent automated form spam.
The submit button will be disabled until you complete the CAPTCHA.