Step 1 of 3 0% Customer Information REBATE OFFERS 7/1/2022 through 6/30/2023I am a URE ELECTRIC member(Required) YES NO Member's Name(Required) First Last Member's Address(Required) 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 Best Contact Phone Number(Required)Customer Type(Required) Residential Commercial Industrial Rebate InformationCheck all that apply(Required) Geothermal Rebate (check issued) Heat Pump Rebate (check issued) Electric Water Heater Rebate (bill credit) Electric Vehicle - Level 2 Charger (check issued) Smart Thermostat (check issued) Geothermal Rebate Information Minimums: Closed Loop: 17.1 EER, 3.6 COP Open Loop: 21.1 EER, 4.1 COPManufacturer(Required) Size (in tons)(Required) EER- Energy Efficiency Ratio(Required) COP= energy out / energy in(Required) Heating Backup(Required) Oil Natural Gas Propane Electric Other Water Heating Option:(Required) Supplemental On-demand Not applicable Loop Type(Required) Horizontal Vertical Pond Open Well Pump & Dump Closed or Open Loop(Required) Closed Loop Open Loop Type of System That Was Replaced(Required) Geo HP Dual Fuel Propane Natural Gas Oil Other Electric New Home Buckeye AC load control switch installed?(Required) Yes No Existing AC Switch Number Cool Returns rebate submitted online?(Required) Yes No Heat Pump Rebate Information ENERGY STAR Minimum - Central System or Ductless Mini Split: Split System: 15.0 SEER, 8.5 HSPF Sgl Pkg Sys: 15.0 SEER and 8.2 HSPFManufacturer(Required) Size (in tons)(Required) SEER = cooling output / energy used (during summer)(Required) HSPF = Heating Seasonal Performance Factor(Required) Heating Backup(Required) Oil Natural Gas Propane Electric Other Type of System That Was Replaced(Required) Geo HP Dual Fuel Propane Natural Gas Oil Other Electric New Home None Ductless Mini-Split System Type Single Zone Multi-Zone Central System Type Split System Single Package System Cool Returns rebate submitted online?(Required) Yes No AC Switch Number Electric Water Heater Rebate Information Standard Storage Tank Units Must be Greater than or Equal to 91% EFManufacturer(Required) Tank Size (in gallons)(Required) Size of Elements (in watts)(Required) EF = Energy Factor indicates a water heater's overall energy efficiency based on the amount of hot water produced per unit of fuel consumed over a typical day.(Required) Type Standard Buckeye AC load control switch installed?(Required) Yes No Existing Load Control Switch Number Type of System That Was Replaced(Required) Electric Propane Natural Gas Fuel Oil Other New Home ENERGY STAR® Logo and rating on EnergyGuide label verified/confirmed(Required) Yes No Electric Vehicle - Level 2 ChargerManufacturer(Required) Model(Required) Number of Ports(Required) County Inspection Complete?(Required) Yes No Smart ThermostatManufacturer(Required) Model Number(Required) Is the Thermostat Wi-fi compatible?(Required) Yes No Is the Thermostat Energy Star Certified?(Required) Yes No Date of Purchase(Required) MM slash DD slash YYYY HiddenDOCUMENT UPLOAD. Please upload all required documentation. (receipts, specs, etc.)Max. file size: 256 MB. DOCUMENT UPLOAD. Please upload ALL required documentation. Multiple files can be uploaded/drag and drop, EXAMPLES: Receipts, Energy Star specs, etc. Drop files here or Select files Max. file size: 256 MB. Customer Agreement & ConsentCustomer Consent(Required) I hereby verify the information to be true and complete. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.Customer Electronic Signature (Full Name)(Required) Untitled First Choice Second Choice Third Choice EmailThis field is for validation purposes and should be left unchanged.
