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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.

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. Is installation complete?

    1. Yes
    2. No. Sorry, not yet eligible for rebate.

    Equipment must be installed and project complete before applying for rebates.

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

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

    1. Single Family Home
    2. Mult-family Dwelling

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

22. 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. Unit #
25. City*
26. State
27. Zip*
29. Email Address*
30. Phone Number*
32. Retailer Information
34. Purchased both Condensing Unit and Coil?*

    1. Yes
    2. No (sorry, does not qualify for rebate)
36. Retailer Name/Store:*
38. Rebate Contact Name
39. Rebate Contact Phone
41. Location/City*
42. State
44. Receipt Date*
    Receipt Date
45. Installation Date*
    Installation Date
47. 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).

49. Equipment Information
51. Is this an energy saving A/C with a SEER2 rating of 15.0 or higher?*

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

    Does not need to be ENERGY STAR®.

53. Efficiency Rate (SEER2 rating)*
55. Size/Capacity*

    (in tons)

57. AHRI Reference Number*

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

59. Upload AHRI Certificate
61. Manufacturer*
62. Condenser Model Number*
63. Condenser Serial Number
65. Is this a replacement appliance?*

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

    1. Yes
    2. No
67. Is the new or existing duct work sealed?

    1. Yes
    2. No
69. Disclaimer & Signature
71. 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.
75. 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.
77. Electronic Customer 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:


79. 1. Receive an email copy of this form.
80. Email address

    This field is not part of the form submission.

81. Submit Submit and Print

* indicates a required field