Please fill out each section and attach the requested documentation. Any questions can be directed to member services at (208) 743-1501. N.E.E.M. 1.1 - $1,000 N.E.E.M. 2.0 - $1,400 Member / Customer InformationName* First Last CPC Account Number* Service Address* Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone*Email Home Heating Information Must be Electrically HeatedHeating* Electric Furnace w/AC Electric Furnace w/o AC Heat Pump Water Heater Fuel Type* Electric Other Date home was set at location* Required PaperworkCertificate of Compliance from the Manufacturer(Completely filled out) Drop files here or Select files Max. file size: 100 MB.
