Вы находитесь на странице: 1из 1

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?



Was existing unit in working order?


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) / /


Backup heating type:

*Must be 65,000 Btu or less


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



Mail Word of Mouth

Internet Search Other:


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.