High-Efficiency Boiler Rebate Application
Applicant Information
Full Name
Street Address
City
State
ZIP Code
Phone Number
Email Address
Property Information
Property Type
Residential
Commercial
Installation Address (if different)
Boiler Information
Boiler Manufacturer
Boiler Model Number
Boiler Serial Number
Installation Date
AFUE Efficiency (%)
Installer Information
Installer Company Name
Installer Contact Name
Installer Phone Number
Installer License Number
Attachments
Upload Purchase Invoice
Upload Proof of Installation