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Residential Central Air Conditioner (A/C) Rebate Form

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

  2. Anoka Municipal Utility (AMU) Rebates
  3. Check this box to acknowledge that you have read and agree to our rebate policy Rules & Requirements.*
  4. Select when purchased:*

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

  5. Anoka Municipal Utility (AMU) Customer Information
  6. Anoka Municipal Utility (AMU) is my electric service provider.*
  7. Building Type*

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

  8. 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.

  9. Retailer Information
  10. 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).

  11. Equipment Information
  12. Is this an energy saving A/C with a SEER rating of 14.0 or higher?*

    Does not need to be ENERGY STAR®.

  13. Purchased both Condensing Unit and Coil?*
  14. The AHRI directory may be found at online or by calling 315-737-5180.

  15. Is this a replacement appliance?*
  16. Old Equipment still working?
  17. *If applicable
  18. If known

  19. HSPF or ASHP?

    *If applicable

  20. Is the new or existing duct work sealed?
  21. Refrigerant Type
  22. Does cooling airflow meet manufacturer's specifications?
  23. Heat loss/gain calculation completed and on file?
  24. 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.

  25. Disclaimer & Signature
  26. Check this box to agree to the following:*
  27. 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.
  28. *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.

  29. Leave This Blank:

  30. This field is not part of the form submission.