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Program dates: January 1, 2022 through December 31,
2022. PLEASE NOTE: This is a program with limited funding.
Applications will be processed on a first-come, first-served basis
until funds are depleted. To check the current status of funds,
please call 855-350-1563.
To receive your rebate, please submit all requested information,
including a copy of the dated invoice from your equipment installer,
along with all requested signatures. The rebate application must
be submitted within 90 days of installation date or within 90 days
of connection of natural gas AND emailed or postmarked by
December 31, 2022. See other side for more information or visit
energy-readyarkansas.com. Please send completed application to:
Energy Ready, P.O. Box 9567, Fayetteville, AR 72702
or bheahes@clearesult.com.
INSTALLATION LOCATION
Account holders name ___________________________
Black Hills Energy Arkansas Account # (required)
_____________________________________________
Phone ( ) ___________________________________
Email ________________________________________
Account location address _________________________
City/State/ZIP __________________________________
Mailing address _________________________________
City/State/ZIP __________________________________
Electric provider:
q
Entergy Arkansas
q
SWEPCO
q
Other ____________
PURCHASER'S INFORMATION
(if different from above)
Business name _________________________________
Mailing address _________________________________
City/State/ZIP __________________________________
Email ________________________________________
Is purchaser:
q
Owner
q
Landlord
q
Renter
q
Agency
INSTALLER
(To be completed by installer. An additional rebate of $50 will be paid to
the installer show below.)
Company name ________________________________
First name ____________________________________
Last name ____________________________________
Address ______________________________________
City/State/ZIP _________________________________
Phone ( ) __________________________________
RESIDENTIAL
HEATING
Equipment Rebate
Email ________________________________________
Installer signature ______________________________
License # _____________________________________
All suppliers must submit a copy of a completed W-9 to the
Black Hills Energy Arkansas Residential Solutions Program
in order to be paid. If you have questions about how to
submit a W-9, please call 855-350-1563 or email
bheahes@clearesult.com.
It is not the responsibly of the installer to ensure that the program
requirements are met. If program requirements are not met, no
rebate will be paid.
Send rebate check to:
q
Purchaser’s address
q
Installation address
q
Assigned installer*
*Rebate assignment requires documentation on invoice discounting
final invoice by the amount of the rebate. If assigned installer box is
checked above, customer signature is required here:
_____________________________________________
Type of installation:
q
New construction
q
Replacement (failure)
q
Replacement (upgrade)
If furnace replacement is due to air conditioning failure, please select
Replacement (upgrade).
Building type:
q
Single-family home
q
Multi-family home
Square footage (required): _____________ square feet
Year of construction (required): ___________________
CUSTOMER SIGNATURE
Signature _____________________________________
Print first and last name __________________________
Date ________________________________________
By signing this application, you certify that the information provided
is accurate to the best of your ability.
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signature
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signature
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signature
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Residential Heating
Equipment Rebate
HEATING EQUIPMENT INFORMATION
(To be completed by installer.)
Brand ________________________________________
Complete model # ______________________________
BTU/Hr. input _________________________________
AFUE % ______________________________________
Date of installation ______________________________
Serial # _______________________________________
QUALIFICATIONS
The qualifying equipment must be installed in an Arkansas home
served with natural gas from Black Hills Energy Arkansas and must
meet the following eciencies:
Rebate oer applies only to new natural gas furnaces. If the
furnace being replaced is electric or is a heat pump, no rebate is
available. Black Hills Energy Arkansas uses Air Conditioning,
Heating, and Refrigeration Institute listings to determine the
eciency of the equipment.
If applying for units in a newly constructed home, rebates are
available for NO MORE THAN 2 units per account.
If sending rebates for multiple accounts or multiple units on one
account, please call to check availability of funding.
Installers are only eligible to receive their customer’s rebate if the
customer has assigned the rebate to the installer, and there is a
discount for the full amount of the rebate shown on the final invoice.
Equipment installed under warranty replacement does not qualify
for the rebate.
REQUIREMENTS
Application must be completely filled out with installation location
information, purchaser information (if applicable), equipment
information (including brand, complete model and serial number,
installation date and AFUE rating) and installer information (if
applicable). Black Hills Energy Arkansas is unable to accept
applications that do not include all this information. A copy of the
dated invoice or sales receipt must accompany the completed
rebate application and must include the customer name, unit brand,
model and serial numbers and unit cost. It is the responsibility of the
account holder or purchaser to ensure that the installed equipment
qualifies for the rebate. If it does not qualify, no rebate will be paid.
Black Hills Energy Arkansas reserves the right to inspect the
installed equipment.
Rebate qualifications and amounts are subject to change.
The rebate application must be submitted within 90 days of
installation date or within 90 days of connection of natural
gas AND emailed or postmarked by December 31, 2022. To
avoid delays in rebate processing, please submit your completed
paperwork as soon as possible. Any applications with missing or
incomplete information can jeopardize the chance of receiving
rebate funds. Rebates are awarded on a first-come, first-served
basis until funds are depleted.
REBATE DETAILS
Rebate amounts will be issued for equipment installed between
January 1, 2022 and December 31, 2022 only. Black Hills Energy
Arkansas issues cash rebates in the form of checks, not utility bill
credits. Black Hills Energy Arkansas is not responsible if the installer
does not provide accurate information on the rebate amount or
equipment eligibility. Rebate checks will be mailed within 6–8 weeks.
APPLICATION CHECKLIST
q
Dated sales invoice must include customer name, equipment
brand, model and serial number and unit cost. If rebate has been
assigned to the installer by the Black Hills Energy Arkansas customer,
the deduction for the rebate must be shown on the invoice.
q
Customer signature
q
Black Hills Energy Arkansas Account #
OPTIONS TO SUBMIT REBATE
1. Email (preferred):
bheahes@clearesult.com
2. Mail: Black Hills Energy Arkansas Rebates
C/O CLEAResult
P.O. Box 9567
Fayetteville, AR 72702
QUESTIONS?
For information pertaining to your rebate, call 855-350-1563
or email bheahes@clearesult.com.
TECHNOLOGY REBATE AMOUNT
Natural gas forced-air
furnaces
$400 (95% AFUE or higher)