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2. Submitting this document electronically will require you to upload documentation such as sales receipt, etc.  Please do not send sensitive information.

3. 
5. Rebate Policy
   Residential Air Conditioning (AC) Rebate

   Check out the Rules & Requirements section to make sure you qualify for this rebate before filling out the form. 

   AMU CUSTOMER SIGNATURE IS REQUIRED.

   *NOTE: Technician's Test Form (PDF) will be required to upload, please have the technician fill it out before completing this online rebate application.

7. Check this box to acknowledge that you have read and agree to our rebate policy Rules & Requirements.*

   1. Yes
9. Select when purchased:*

   1. Receipt dated within last 12 months.
   2. Receipt older than 12 months from current date. (Sorry does not qualify)

   Customers must apply for rebates within twelve (12) months of the purchase date shown on the sales receipt.

11. Anoka Municipal Utility (AMU) Customer Information
13. Anoka Municipal Utility (AMU) is my electric service provider.*

    1. Yes
    2. No, sorry this program is for AMU customers only.
15. Customer First Name*
16. Customer Last Name*
18. Building Type*

    1. Single Family Home
    2. Mult-family Dwelling

    Multi-family example includes Apartment, Townhome, Duplex, etc.

19. Unit #
21. Service Address*

    Rebate amount will be credited to your AMU billing account. No need for a mailing address. This must be the location of the installation for the rebate.

23. City*
24. State
25. Zip*
27. Phone Number*
28. Email Address
30. Retailer Information
32. Retailer Name/Store:*
34. Rebate Contact Name
35. Rebate Contact Phone
37. Location/City*
38. State
40. Receipt Date*
    Receipt Date
42. Upload Your Invoice/Receipt*

    Invoice/Receipt(s) submitted must include the Purchase date, Installation date, Manufacturer, Model number, Serial number, ARI reference number, Size or Capacity, and Efficiency (SEER).

44. Upload AHRI Certificate
46. Upload more Documentation (optional)
48. Equipment Information
50. Is this an energy saving A/C with a SEER rating of 14.0 or higher?*

    1. Yes
    2. No, sorry does not qualify for rebate.

    Does not need to be ENERGY STAR®.

51. Purchased both Condensing Unit and Coil?*

    1. Yes
    2. No (sorry, does not qualify for rebate)
52. Purchase Date*
    Purchase Date
53. Installation Date*
    Installation Date
55. Manufacturer*
56. Condenser Model Number*
57. Condenser Serial Number
59. AHRI Reference Number*

    The AHRI directory may be found at online or by calling 315-737-5180.

60. Efficiency Rate (SEER rating)*
61. Size (in tons)*
63. Is this a replacement appliance?*

    1. Yes
    2. No
64. Old Equipment still working?

    1. Yes
    2. No
65. Old HSPF
    *If applicable
66. Old SEER rating

    If known

68. HSPF or ASHP?

    1. Heating System Perform Factor (HSPF)
    2. Air Source Heat Pump (ASHP)

    *If applicable

69. Is the new or existing duct work sealed?

    1. Yes
    2. No
70. Refrigerant Type

    1. R410 A
    2. R22
    3. Other
71. Other
73. Startup/Test date*
    Startup/Test date
74. Outside Temperature at time of testing
75. Does cooling airflow meet manufacturer's specifications?

    1. Yes
    2. No
76. Heat loss/gain calculation completed and on file?

    1. Yes
    2. No
78. Technician's Airflow Test Form
    Technician's Test Form

    If you haven't already done so, have the Technician complete the Airflow Tests and appropriate Refrigerant Charge Tests using the link to this form. Save a copy of completed form and upload to this rebate application.

80. Upload Installation Technician's Airflow Test*

    Only our Technician's Airflow Test Form is acceptable.

    Testing depends on whether the system is TXV or non-TXV, using the appropriate reference charts. Note that the outdoor temperature must be at or above the minimum specified by the manufacturer for testing to take place.

82. Disclaimer & Signature
84. Check this box to agree to the following:*

    1. I certify that all the information provided is accurate including claims of efficiency, size and customer information. I agree that AMU may verify all the information I have provided.
88. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
90. Customer Electronic Signature*

    *Must have an AMU account holder name here.  Any other name not listed on the utility bill will result in rejection of this rebate application.

Leave This Blank:


92. 1. Receive an email copy of this form.
93. Email address

    This field is not part of the form submission.

94. Submit Submit and Print

* indicates a required field