Residential Heat Pump Water Heater Rebate Application Asterisks (*) indicate required fields.CONSUMER INFORMATIONAccount Number* Are you the account holder?* Yes No Relationship to Consumer (if not account holder)* Family Member Landlord Tenant Applicant Name* First Last Phone*Email* Installation Address* Street Address City 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 State ZIP Code Do you have a different mailing address?* My mailing address is the same as above I have a different mailing address Mailing Address* Street Address City 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 State ZIP Code HOME INFORMATIONExisting Water Heater Type:* Electric Gas Unfortunately, the existing water heater must be electric to qualify for the rebate.Home Type:* Site Built Manufactured New Construction Location of the water heater:* Conditioned (heated space) Unconditioned (unheated space) Installer:* Contractor Homeowner Installation Date* MM slash DD slash YYYY (Enter the estimated date if not installed yet)NEW EQUIPMENTOnly certain heat pump water heaters are eligible for the rebate. Please click the button below to find current rebate amounts as well as the qualified products list for heat pump water heaters. This will open a new tab. Rebate Amounts Have you already purchased a new Heat Pump Water Heater?* Yes, I have already purchased I have not made a purchase yet If you have not yet purchased a new Heat Pump Water Heater, you may submit this application for preapproval. Submitting for preapproval will confirm your eligibility for the rebate prior to purchasing new equipment.Water Heater Brand* Model Number* Tier Level Tier 1 Tier 2 Tier 3 or higher Rebate(s) will not exceed 70% of the total heat pump water heater cost and does not cover the cost of installation. Limit of one heat pump water heater per site location. UPLOAD RECEIPTPlease attach an invoice or receipt for the purchase of your new Heat Pump Water Heater. Receipt must include the brand, model number, cost, and date of purchase. Please note: To receive the current rebate amount, the attached invoice and installation date must be on or after October 1, 2019.*Max. file size: 20 MB.Please attach an invoice or receipt for the purchase of your new Heat Pump Water Heater. Receipt must include the brand, model number, cost, and date of purchase. Please note: To receive the current rebate amount, the attached invoice and installation date must be on or after October 1, 2019.HiddenHidden BreakApplication NotesPlease insert any notes that you would like us to review with your application.SUBMIT YOUR APPLICATIONTerms and Conditions*By clicking "submit," the applicant acknowledges the following: Rebate offer(s) may be changed or discontinued at any time by Columbia Basin Electric Cooperative (CBEC). CBEC disclaims any warranty, whether expressed or implied, regarding the product listed above for any materials or labor associated with installation, maintenance, repair, or any energy savings associated with use. Rebate offer(s) apply to new product(s) only. CBEC reserves the right to inspect the installed product. The HPWH must meet all program criteria to qualify for rebate. I understand the above and certify that I am a consumer of CBEC, that the HPWH is installed and operating at the location indicated and that this address is within the CBEC service territory. I agree Allow 8 to 10 weeks after final inspection approval and receipt of all required documentation for rebate checks to be issued and mailed. Call 888-883-9879 to learn about additional energy efficiency programs.