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PPL Electric Utilities E-power Replacement Air Source Heat Pump Rebate Application Form

Requests must be postmarked within 180 days from date of installation.


PPL Electric Utilities 10-Digit Account # Customer Contact First Name Service/Installation Address 1 City Customer Address 1 (If Different From Above) City Email Address Last Name Service/Installation Address 2 State Customer Address 2 State ZIP Telephone Number ZIP Date

Is natural gas distribution service available for your home?

Yes

No

Was existing unit in working order?

Yes

No Propane Furnace

SEER Or Manufacture Date:


(permanently installed, not space heaters)

Does your new electric equipment replace: New Condenser Brand Coil Model Cooling Capacity* (Btu/hr)

Natural Gas Furnace

Oil Furnace Other:

Electric Heat

No Previous Heating System

Size (In Btu):

Condenser Model Air Handler/Furnace Model Heating Capacity (Btu/hr) HSPF Select Rebate Amount: SEER

Installation Date (MM/DD/YYYY) / /

EER

Backup heating type:


*Must be 65,000 Btu or less

Gas/Oil

Electric Resistance

(18,000 - 65,000 Btu/hr)

SEER 15: $100

SEER 16 & above: $200

How did you first hear about E-power rebates? Required Document Checklist:

PPL Bill Insert PPL Website

Newspaper/Print Digital Banner

Radio Contractor

Television

Email

Mail Word of Mouth

Internet Search Other:

In-Store/Salesperson

AHRI Certificate

Copy of Customers Invoice

Signed & COMPLETED Rebate Form

I certify that all information on this form is correct to the best of my knowledge and that I will adhere with all terms and conditions of this rebate. I understand PPL Electric Utilities reserves the right to audit my rebate application and if requested, I will allow PPL Electric Utilities representatives reasonable access to verify the installation of qualifying measures. I also understand that failure to allow an inspection within 60 days may result in forfeiture of the rebate amount. Signature Date

Rebate Submission Guidelines


Please submit a separate rebate application form for each system installed. To be eligible, the new air source heat pump (ASHP) system must: 1. 2. 3. 4. 5. Be installed at a location receiving residential electrical service from PPL Electric Utilities. Be an ENERGY STAR-rated ASHP. Have a cooling capacity between 18,000 and 65,000 btu/hr. Meet minimum efficiency standards. ASHP systems must have an HSPF 8.2, a SEER rating of 15 AND an EER 12. Be rated by the Air-Conditioning, Heating and Refrigeration Institute (AHRI). AHRI certificates may be downloaded at ahridirectory.org and must accompany rebate submissions. Rebates will be paid based on the AHRI certificate efficiency.

(!) IMPORTANT: Photocopy your entire submission for your records. You could be required to mail, email or fax these photocopies.

You must send completed rebate application form within 180 days to pplhome@clearesult.com or mail to: E-power Home Comfort Program, 525 Greenfield Rd, 2nd floor, Lancaster, PA 17601
Please allow two to four weeks for processing. Must be installed by participating contractor. For a list of PPL Electric Utilities participating contractors or additional program information, call toll-free 877-486-9204 or visit eeprograms.net/ppl.

6. Be installed in conjunction with a new evaporator coil.


ENERGY STAR is a voluntary program that helps businesses and individuals save money and protect our climate through superior energy efficiency.
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