Residential High Efficiency Peak Shave Water

2025 Rebate Application

Member Information:

Name

Account Number

Address where appliance is installed

City/Town

State/Province

ZIP/Postal Code

Phone Number

Member Type

Homeowner

Renter

Landlord

Builder

Other

Signature

By signing this application, I certify the appliances for which I am claiming a rebate are qualifying products and are installed at the address listed above which represents a valid Itasca-Mantrap account.

Today's Date:

Credit my account

Send a check

Equipment Information

Rebate Type

New Construction

Retrofit

Old water heater information: (Skip to new water heater information if applying for new construction rebate)

Water Heater Manufacturer

Model Number

New water heater information:

Water Heater Manufacturer

Model Number

Water heater capacity

Efficiency rating

Installing Contractor

Date Installed

Retailer Information

Retailer/Store Name

Location

Rebates are available only for the purchase of new high efficiency* water heaters installed on or after January 1, 2025. The water heater must be installed where electricity is supplied by Itasca-Mantrap. Rebate submittal must follow the guidelines as listed below. Itasca-Mantrap is not responsible for inaccurate information supplied by retailers/contractors. Rebate program is subject to change or cancellation without notice. Call Itasca-Mantrap to verify rebate program status. *Installed water heater must meet the energy factor of .90 or higher to qualify for the rebate. Please include verification of energy factor. Verify application requirements with Itasca-Mantrap.

Important:

• Rebate amounts: New construction or Retrofit: $300

• Limit one rebate per application.

• The water heater must be installed within Itasca-Mantrap’s service territory.

• Incomplete forms will not be processed.

• Water heaters must be high-efficiency with an energy factor of .90 or higher. Please include a copy of proof of efficiency.

• Water heaters must be controlled on a peak shave water heater program. Water heater must have minimum capacity of 50 gallons.

• Include a copy of the original dated sales receipt.

• Complete all member information including your account number and sign this form.

• Submit completed rebate form and a copy of the original sales receipt within 90 days of purchase date to: Itasca-Mantrap, PO Box 192, Park Rapids, MN 56470 • For questions, contact Itasca-Mantrap at 218-732-3377 or toll free at 888-713-3377.

This institution is an equal opportunity provider.