Purchaser type
Owner
Is this a replacement water heater?
Landlord
Builder
Agency
Type of building
Single-family
Duplex
Three-plex
Yes
No
New construction
Addition/Remodel
Townhome - Attached
Townhome - Detached
Four-plex
How did you learn of this program?
Dealer/Plumber
Bill insert
Web site
Retail store
Friend or relative
Did this rebate program influence your purchase of a high-efficiency water heater?
Yes
No
Would you have purchased a high-efficiency water heater without this rebate?
Yes
No
Please read the following and respond to question #3.
Above
Below
.62 + EF Water heater
$50 rebate
.64 + EF Water heater
$75 rebate
CNP 1007 (10-2008)
RESIDENTIAL WATER HEATER REBATE
Program dates: Jan. 1, 2009 through Dec. 31, 2009
This rebate offer applies only to new atmospheric, direct or power vent water heaters. Please complete one form per water
Please send completed form to: CenterPoint Energy Water Heater Rebate, PO Box 59038, Minneapolis, MN 55459-0038.
Purchaser's name
Home phone ( )
PURCHASER INFORMATION
Daytime phone ( )
Address
If different from above, name and address where water heater will be installed
Required: CenterPoint Energy acct # or meter # where appliance is being used
City / State / Zip
Date
EQUIPMENT INFORMATION
The Minnesota Department of Commerce requests that CenterPoint Energy track the following
information for reporting purposes only.
Find your household size on the table to your right.
Determine your annual household income, before taxes, including pension, social security, etc.
Is your household income above or below the amount corresponding to your household size in
this table?
# of people
in household
1
2
3
4
5 or more
Annual household
income
$21,184
$27,702
$34,220
$40,738
$47,256
Purchaser's signature
X
Brand
Complete model #
Serial #
Size or capacity/gallons
Energy Factor
2009 Date of installation
It is the responsibility of the purchaser to ensure that the program requirements are met. If program requirements are not met, no rebate
will be paid.
White - CenterPoint Ener