Step 1 of 6 0% Download the Residential Water Heater Application (PDF) or fill out the online form. Residential Water Heater Water heating is the second-largest energy expense in most households, accounting for around 18% of the power bill. That means the type of water heater and how you use it is very important. Water heaters and heat pump water heaters have come a long way in efficiency standards. New energy-efficiency storage water heaters contain high levels of insulation around the tank to reduce standby heat loss, and heat pump water heaters, Like your heat pump HVAC unit, utilize the air around them to heat your water. Both can save you up to $550 a year. We understand cost is always a factor when upgrading your equipment so RushShelby Energy would like to help you with that by providing a small incentive. Simply fill out the application in its entirety and send it with your invoice noting manufacturer/brand, model #, and cost of your new water heater and proof of your water heater's UEF rating. We also suggest checking out Indiana's Residential and Homeowner Incentives webpage for more information on tax credits and their upcoming energy efficiency incentive programs. www.in.gov/oed/grants-and-funding-opportunities/homeowner-incentives/Terms & Conditions Must be installed in a home served by RushShelby Energy. Limit of two (2) rebates allowed per member account per useful life of rebate equipment. Minimum UEF rating ≥ 0.90 Must submit signed application with itemized invoice/receipt and proof of UEF rating. Wi-Fi unit must be built into the water heater when purchased and not a stand-alone equipment piece. The incentive amount cannot exceed 50% of equipment cost. Please review the complete list of terms and conditions. Member InformationName(Required) First Last Account Number(Required) Meter Number(Required) Address(Required) Street Address Address Line 2 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 Email(Required) Phone(Required)Cell PhoneContractor's Name(Required) First Last Contractor's Mailing Address(Required) Street Address Address Line 2 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 Building Type(Required) Residential: Mobile/Manufactured Residential: Single Family Occupancy Status(Required) Owner Renter Vacant Tenant Landlord Construction Type(Required) New Construction Existing Home Housing Type(Required) Stick-Built or Modular Mobile or Manufactured Home Year Home Was Built(Required) Total Project Invoice Cost(Required) Will Rebate Be Mailed to Contractor Instead of Being Claimed by the Member?(Required) Yes No Member Applicant Assignment of Payment to Non-Applicant/Contractor/Vendor(Required) I assign the full Team Up incentive amount pursuant to this application to the individual or entity designated as "Contractor" listed above and agree that such assignment can only be amended or modified in writing acknowledged by member cooperatives and Hoosier Energy, and further agree to hold harmless and indemnify member cooperatives and Hoosier Energy from any claim made for such incentive amount or from any loss resulting from the payment of the incentive amount to the assignee.Member Electronic Signature (Full Name)(Required) Rebate Type(Required) Water Heater HVAC InformationHVAC Installation Date (mm/dd/yyyy)(Required) Month Day Year Installation Type: Equipment Must Be Installed in Primary Residence(Required) Replacing Existing A/C or Heat Pump; or New Construction Install (ASHP, MSHP, or GHP Heat Pump Type) Replacing 100% Electric Resistance* (HPRER or DMSHP Heat Pump Type) HPRER Must be Primary Heat Source to Home *Not qualified for 100% Electric Resistance Replacement: Heat pump with electric resistance, space heaters, gas furnace, wood stove, wood pellet, A/C, back-up heatExisting or New Construction(Required) Existing Home New Heat Pump Install New Construction Install Replacing Existing A/C Replacing Existing Heat Pump What Type of Heat is Being Replaced?(Required) Electric Coil Furnace Baseboard Ceiling Cable Other Heat Pump Type(Required) Air Source (ASHP) — $750: Dual/Variable/Multi-Speed Compressor is Required Geothermal Heat Pump (GHP) — $1,500 Electric Resistance Replacement Air Source/Dual Fuel (HPRER) Ductless Mini-Split Heat Pump (DMSHP) Geothermal Heat Pump(Required) Single Speed Compressor Dual/Variable/Multi-Speed Compressor Desuperheater Installed?(Required) Yes No Propane/Gas Back-Up?(Required) Yes No Electric Resistance Replacement Air Source/Dual Fuel(Required) Single Speed Compressor — $800 Dual/Variable/Multi-Speed Compressor — $1,500 Ductless Mini-Split Heat Pump(Required) Single Room Installation* — $300: (Variable/Multi-Speed Compressor is Required) Replacing Existing A/C, HP, or New Construction Electric Resistance Replacement *Single room installation can include room additions or outbuildings. Must be located and serviced by member on account and must be occupied/used year-round (seasonal occupance does not qualify).Replacing Existing A/C, HP, or New Construction Whole-Home, Variable/Multi-Speed Compressor — $750 Electric Resistance Replacement Whole-Home, Variable/Multi-Speed Compressor — $1,500 Does the Heat Pump Have a Gas Furnace? (Dual Fuel) Yes No Gas Furnace Annual Fuel Utilization Efficiency (AFUE) Fossil Fuel Type Quantity of Outdoor Units Installed(Required) Quantity of Indoor Units Installed(Required) Manufacturer(Required) Purchased From:(Required) Heat Pump Equipment Cost (Excluding labor costs)(Required) British Thermal Units (BTUs)(Required) Size (Tons)(Required) Air-Conditioning, Heating, and Refrigeration Institute (AHRI) Seasonal Energy Efficiency Ratio (SEER) Rating(Required) Outdoor Unit Model Number(Required) Outdoor Unit Serial Number(Required) Indoor Unit Model Number(Required) Indoor Unit Serial Number(Required) Installed by:(Required) Building Contractor's Name(Required)HVAC Contractor must indicate on the invoice, whether a single or dual/variable speed compressor was installed. File Upload(Required)AHRI Certificate and Invoice/Receipt (Required) Drop files here or Select files Max. file size: 300 MB. Limit of 2 rebates per household. Rebates for HVAC equipment are available for whole home installations only unless otherwise stated. To receive a rebate, all homeowners must provide AHRI validation for all SEER and EER ratings that can be obtained from the installing heating and cooling dealer. No rebate will be awarded based on HVAC dealer bid specifications, promotional material of dealer, manufacturer, or any other source than AHRI. A certificate of AHRI-certified performance must be submitted. All homeowners must complete this rebate application form and provide proof of purchase to receive any rebate. The cooperative reserves the right to approve, deny, or select the appropriate rebate. The co-op also reserves the right to inspect and verify the installation of equipment receiving a rebate. Water Heater InformationWater Heater Installation Date (mm/dd/yyyy)(Required) Month Day Year Number of Units Installed(Required) Equipment Cost (Excludes Labor)(Required) Type of water heater:(Required) $500 – Heat Pump water heater $200 – Wi-Fi enabled electric storage water heater Manufacturer(Required) Purchased From:(Required) Unit Model Number(Required) Unit Serial Number(Required) Size (Gallons)(Required) UEF Efficiency Rating(Required) Type of Home HVAC(Required) Installed By:(Required) Building Contractor(Required) File Upload(Required)Invoice or Receipt (Required)Max. file size: 300 MB.Limit of 2 water heater rebates per household. All homeowners must complete this rebate application form in its entirety and provide proof of purchase to receive any rebate The cooperative reserves the right to approve, deny, or select the appropriate rebate. The co-op also reserves the right to inspect and verify the installation of equipment receiving a rebate. Agreement & SignatureMember Consent(Required) I hereby verify the information to be true and complete and agree to the terms and conditions. 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. All rules and requirements of this program have been followed. Applicant has read and agrees to the Residential Rebate Program Terms and Conditions. Applicant is a residential member of RushShelby Energy, and electric cooperative member of Hoosier Energy. The rebated equipment was installed and operational prior to submission of this application. RushShelby Energy is providing the electric service to the installation site address listed on this application. Rebated equipment is installed in the primary residence of the applicant. Applicant understands and agrees that neither Hoosier Energy nor RushShelby Energy assumes any responsibility or liability arising out of or related to applicant's participation in Team Up programs. Applicant will allow inspection of the rebated equipment (if requested). Applicant understands applicant will not receive a rebate if applicant and/or applicant's contractor fails to provide required program documentation. Applicant agrees to purchase power from RushShelby Energy for a period not less than the deemed measured useful life of rebated equipment. Should the applicant receive power from any source other than the electric cooperative, including generation owned by the customer, before the end of the equipment's deemed useful life, the applicant agrees to refund the full amount of the rebate to the distribution cooperative. Applicant gives permission to Hoosier Energy to obtain usage information from their electric cooperative. Applicant understands that Hoosier Energy may use the usage information provided for program evaluation and analysis. If signing in a capacity other than an individual capacity, the individual signing below hereby represents and warrants that they are duly authorized to execute and deliver this application on behalf of the applicant. RushShelby Energy reserves the right to approve, deny, or select the appropriate rebate amount. Member Electronic Signature (Full Name)(Required)
