Heat Pump Water Heater Rebate Application

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

** If you choose to download the form, please fill out, scan and send to ahout@missionvalleypower.org

Heat Pump Water Heater Rebate Form

Conservation Rebate for Heat Pump Water Heater Installations

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

Manufacturer:(Required)

Model Number:(Required)

Size of Water Heater (in gallons):

Number of Units

Total Rebate Amount Due ($300 per water heater):

Receipt of Purchase/Invoice with Order Date & Signature of Certified Installer:(Required)

Drop files here or

Accepted file types: jpg, pdf, jpeg, gif, png, tiff, Max. file size: 10 MB.

Yellow Energy Guide Sticker or Label from Shipping Box:(Required)

(w/Model # & Energy Factor Noted)

Drop files here or

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

I certify that this water heater 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 water heater.

Customer Signature:(Required)

Installer's Signature:(Required)

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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