Comments

This field is for validation purposes and should be left unchanged.

To qualify for a billing credit or check the unit must be an existing single family and use electric resistance as their primary heat source.

New Construction does not qualify.

Date(Required)

Account #(Required)

Location Number

Name(Required)

First Last

Phone Number:(Required)

Email Address:

Mailing Address(Required)

Street Address City State ZIP Code

Install Address(Required)

Street Address City State ZIP Code

Phone # of Residence (if different):

New Construction(Required)

Yes

To qualify for a billing credit or check the unit must be an existing single family and use electric resistance as their primary heat source.

New Construction does not qualify.

Year Home was Built(Required)

Type of Construction(Required)

Site Built

Manufactured Home

Style of Home:(Required)

Single Family

Duplex

Triplex

Fourplex

Type of Electric Heating System:(Required)

Baseboard

Wall

Ceiling

Forced Air

Boiler

Other

Type of Auxiliary Heat:(Required)

Propane

Wood

Pellet

Fuel Oil

Other

None

Manufacturer:(Required)

Model Number:(Required)

Installed SEER Rating

Installed HSPF Rating

Number of Systems

Total Rebate Amount Due:

($920 if all electric or $450 if you have non-electric auxiliary heat. Add $250 for each additional system in the same home.)

Credit to account or Check Payment(Required)

Credit To Account

Check To Customer

Social Security Number(Required)

Receipt of Purchase(Required)

Drop files here or

Accepted file types: jpg, pdf, jpeg, gif, png, tiff, Max. file size: 50 MB.

AHRI Sheet(Required)

Drop files here or

Accepted file types: jpg, jpeg, tiff, gif, png, pdf, Max. file size: 50 MB.

Yellow Energy Guide Sticker(Required)

Drop files here or

Accepted file types: jpg, pdf, png, gif, jpeg, tiff, Max. file size: 50 MB.

***As the homeowner I certify that this appliance was purchased for installation at the above address. I will allow a representative of Mission Valley Power and/or Bonneville Power Administration to verify installation of the energy efficient appliance.***

Customer Signature:(Required)

***The following sections must be filled out by the installer upon installation in accordance with utility policy. Eligibility Guide for DHPs and Ducted Mini-Splits: Ducted Mini-Splits do not include homes with whole house centrally ducted systems. All systems must:

1. Be installed in an existing home, New Construction does not qualify,
2. Be installed on a dedicated electrical circuit,
3. Have refrigerant line protection on the entire length of exterior and insulated refrigerant lines,
4. Be installed in accordance with manufacturer specifications, including adherence to proper refrigerant charging.

Select what you are Installing (Select One):(Required)

Single Indoor Head DHP

Single Ducted Mini-Split (not whole home centrally ducted)

Multi Indoor Head DHPS

Multi Indoor Ducted Mini-Splits (not whole house centrally ducted)

Combination DHP/Ducted Mini-Split

Eligible Home Types - Single DHP(Select One):(Required)

Existing Single Family

Existing Manufactured

Eligible Home Types- Multi Head (Select One):(Required)

Existing Single Family

Note: Multi-head DHPs, Multi Ducted mini-splits and combination installs in New & Existing Manufactured Homes or New Single Family Homes may be eligible for singe indoor head DHP or single ducted mini-split incentives. Select one from the previous menu.

Eligible Existing Heat System Being Replaced (Select One):(Required)

Electric Forced Air Furnace

Electric Zonal*

*Zonal heating includes electric, non-ducted: ceiling cable, wall, baseboard, plug-in and electric boiler/water heater attached to a zoned hydronic floor heating system.

Total Heated Area of Home (sf):(Required)

AHRI Certificate Ref. #:(Required)

HSPF Rating:(Required)

Installation Date:(Required)

Outdoor Unit Manufacturer:(Required)

Outdoor Unit Model(s) #:(Required)

If multiple Outdoor Units, please list all with commas between

Indoor #1 Model Number:(Required)

Indoor #2 Model # (if installed):

Indoor #3 Model # (if installed):

Indoor #4 Model # (if installed):

Total Installed Cost (before rebates):(Required)

Installer Signature:(Required)

Lobby Hours

Drive Thru Hours

After Hours 406-883-7972

Office 406-883-7900

After Hours 406-883-7972

Office 406-883-7900

Ductless Heat Pump Rebate Application

Fill out the form below online or click here to download the form

Ductless Heat Pump Rebate Form

Please allow up to 8 weeks for the billing credit to be issued to your account after submitting your completed application and all required documentation.

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Lobby Hours

Drive Thru Hours