Heat Pump Rebate Application Form

Customer Information

Name(Required)

First Last

Clearwater Power Account Number(Required)

Email(Required)

Phone(Required)

Installation Address(Required)

The physical location for this project/application

Street Address City State ZIP Code

Is this also your mailing address?(Required)

Yes, this is also my service address for this application

No, this rebate application is for a different address

Mailing Address(Required)

Street Address City State ZIP Code

Home Type(Required)

Sections

Year Built

Square Feet

Old Heating System

Air Conditioner?

Heat Pump System Installed

Mini-Split Type

Indoor Units

Please Upload Supporting Documents

Must Upload: Invoices/Receipts with Model Numbers, AHRI Certificate (and Compressor Spec Sheet if applicable) Photos of previous system are requested but not required.

Drop files here or

Max. file size: 100 MB.

Invoices/Receipts with Model Numbers(Required)

I have uploaded a copy of my receipt or invoice with model numbers

AHRI Certificate (and Compressor Spec Sheet if applicable)

I have uploaded a copy of my AHRI certificate

Approval Agreement(Required)

I hereby request an incentive for the above listed item(s) and understand that all incentives are subject to an approval process from Clearwater Power Company and Bonneville Power Administration according to their approved measures implementation manual.

Processing Agreement(Required)

I understand that rebates typically require 6-8 weeks for approval and processing.

Funding Source(Required)

I understand that this rebate cannot be funded by any other sources.

Attestation(Required)

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