Geothermal Heat Pump Rebate

Application Form

Homeowner's Name:

Purchase Date:

All documentation must be submitted within 60 days of purchase date.

Installation Address:

Cleco Meter # (starts with 168):

Can be found on your bill in the Billing Details section.

City:

City (if not listed in Drop-down)

Zip Code:

Daytime Phone # (no spaces, and include area code):

Parish:

Email Address

Mailing Address (if different from install address)

Mailing Address:

Mailing City:

Mailing Zip Code:

Mailing State:

Geothermal Heat Pump Details

System Brand

Model #

System Type

System Size (up to 65,000 Btuh)

System EER

System COP

Desuperheater (choose one)

Yes
No

Contractor Company Name

Daytime Phone # (no spaces, and include area code):

Contractor Email

Geothermal Heat Pump Rebate Requirements

In order to qualify for this rebate, the geothermal heat pump must meet the minimum requirements of the ENERGY STAR Tier 3 geothermal heat pump key product criteria and the model number must be listed on the ENERGY STAR website at https://www.energystar.gov/productfinder/product/certified-geothermal-heat-pumps/results

Required Documentation

Proof of Purchase

AHRI Certificate for installed unit

Signature

By submitting below, the purchase certifies that the geothermal heat pump for which you are claiming a rebate is installed at the address listed above and authorizes Cleco to perform a phone survey or physical inspection to confirm installation. All rebate forms must be received within 60 days of purchase date of your new geothermal heat pump.

Program funding is limited and participation is on a first-come, first-served basis. Offerings are subject to change without notice.

Please allow 4-6 weeks for processing. For more information about this and other energy efficiency programs, visit www.cleco.com/powerwise or call 1-833-373-6842.

Signature

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