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 including all required documentation.

ONLY TIER 3 OR 4 HEAT PUMP WATER HEATERS QUALIFY FOR THIS REBATE. PLEASE VISIT: HPWHs FOR QUALIFYING PRODUCTS.

Heat Pump Water Heater Rebate Form

Conservation Rebate for Heat Pump Water Heater Installations

Phone

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

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):

Water Heater must be Tier 3 or Tier 4 to qualify for a rebate. Please visit NEEA HEAT PUMP H2O HEATERS to ensure your equipment qualifies.

New Construction(Required)

Yes

Manufacturer:(Required)

Model Number:(Required)

Size of Water Heater (in gallons):

Number of Units

Total Rebate Amount Due ($1400 per water heater):

Receipt of Purchase/Invoice with Order Date(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)

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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