Rebate Program - Request Forms

Upon request, members will be mailed a rebate request form to complete and return. If the member installed any of the equipment themselves, they need to send a copy of the receipt for the equipment with this form. If someone installed the equipment for them, there is a place on the rebate form for that individual to sign certifying that they did install the equipment at this location.

Remember . . . rebates need to be paid within 6 months of the date of installation.  Depending upon when the member returns the form to our office, the rebate check can normally be written within 1 to 2 weeks of the date it is returned.

To electronically request that a rebate form be sent to a member, submit as much of the information below as you can to Central Dictation.  All necessary paperwork will be mailed to the member.

 Employee Name/Initials:
  
Name on PEC Account:
 Home Phone:
Mailing Address:
 City:
 Zip Code:
Account Number:
Heat Pumps:
Total # Installed:
Size of Heat Pump #1 (tons):
 (BTUs):
Size of Heat Pump #2 (tons):
 (BTUs):
Date of Installation: (xx/xx/xx):
Name of individual or company who installed heat pump(s)--if known:
Water Heaters:
Total # Installed:
Size of Water Heater #1 (gallons):
 Date of Installation (xx/xx/xx):
Size of Water Heater #2 (gallons):
 Date of Installation (xx/xx/xx):
Name of individual or company who installed water heater(s)--if known:
Was old water heater electric or gas?

Enter any comments below:



this form and try again.