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Water Heater Rebate Form

Water Heater Rebate

THIS RESIDENTIAL REBATE FOR HEAT PUMP / HYBRID WATER HEATERS ONLY.
To qualify, you must occupy the home where equipment is installed year-round.

Please provide the following documents to your electric cooperative to apply for possible rebates:
– 2024 HPWH Residential Rebate Application
– Proof of purchase (invoice or receipt)

Your application must be completed and signed, as well as submitted within 30 days of the installation date.

Member Name
Member Name
First
Last
Street Address
Street Address
City
State/Province
Zip/Postal
My signature below expressly indicates my understanding and agreement to the program rules and conditions and the following information is true and accurate.