Appliance Rebate Form

Please fill out each section and attach the requested documentation. Any questions can be directed to member services at (208) 743-1501.

Member / Customer Information

Name*

First Last

CPC Account Number*

Email

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Service Address*

Street Address City State ZIP Code

Phone*

Email*

EnergyStar® Clothes Washer

Brand

Model Number

Water Heater

Electric
Gas

Dryer

Electric
Gas

EnergyStar® Clothes Dryer

Brand

Model Number

Type

Heat Pump Unit
Vent-less

Heat Pump Water Heater

Brand

Model Number

Required Documents

Copies of receipts which include model numbers are required for rebate processing*

Drop files here or

Max. file size: 100 MB.

Agreement

Applicant Agreement*

I hereby request an incentive for the above listed item(s) and agree to the BPA terms and conditions. I understand that final approval will be determined by Clearwater Power Company and could take 6 to 8 weeks to be processed.

Applicant Consent*

I hereby verify the above information to be true and complete. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.

Applicant Electronic Signature (Full Name)*