Heat Pump Water Heater Rebate Claim Form (review 10.10.2022)

$850 Rebate

Requirements

Purchased by June 30, 2023
New and installed in Maine
ENERGY STAR® certified
Rebate claim form emailed within 90 days of purchase
Copy of receipt/invoice showing purchase date, price, and model number with submission
W-9 needed if mail-in rebate is for a business

"*" indicates required fields

First Name*

Last Name*

Installation Address (No PO boxes)*

Street Address

City

State

ZIP Code

Phone*

Email*

This appliance is for a:*

Home

Business

Rebate check will be issued to:*

Installer

Customer

Make check payable to: (if different)

Check Mailing Address (if different)

Street Address

City

State

ZIP Code

Water Heater Make/Model*

Store Name*

Installer Company Name*

Installer Company Phone

Purchase Date*

Attach Receipt*

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 32 MB.

Attach a copy of receipt/invoice showing the purchase date, price, and model number.

Certification*

I certify that this information is correct.

By submitting this claim, I understand that Efficiency Maine may contact me to verify installation or ask about my experience. I consent to receive program-related email and/or phone communications from Efficiency Maine and its service partners.

Terms and Conditions

Instant discounts cannot be combined with mail-in rebates. One heat pump water heater rebate or instant discount per installation address per calendar year. Incentive not to exceed purchase price. Instant discount only valid at participating distributors and retailers. Unit must be new and installed in Maine. Efficiency Maine does not warrant product performance. Program is subject to change or termination without notice. Incomplete information may delay or disqualify your rebate.