Ductless Heat Pump Rebate Application

For Ductless Heat Pump (DHP) and Ducted Mini-Split


All sections must be filled out by the installer at the time of installation. A copy of this completed form, the purchase receipt or invoice, and the manufacturer's Installation Checklist must be promptly submitted to the homeowner's utility in accordance with utility policy.

Eligibility Guide for DHPs and Ducted Mini-Splits: Ducted Mini-Splits do not include homes with whole house centrally ducted systems. See PTCS Air Source Heat Pumps for further information on whole home centrally ducted systems.

Household Information

Jefferson County PUD Customer Name(Required)
Available on PUD bill or in Smart Hub App
Mobile or home phone
Installation Address(Required)
Needs to be the same as PUD customer's service address.
Where Should the Rebate Check Be Mailed To?(Required)

Installation Information

Select what you are installing¹
(Select One)
Eligible Home Types
(Select One)
Eligible Existing Heating System²
(Select One)

1Multi-head DHPs, multi ducted mini-splits and combination installs in New & Existing Manufactured Homes or New Single Family Homes (in all states except WA) may be eligible for single indoor head DHP or single ducted mini-split incentive (see above).
2Zonal heating includes electric, non-ducted: ceiling cable, wall, baseboard, plug-in and an electric boiler. water heater attached to a zoned hydronic floor heating system.

Please enter a number from 0 to 10.
MM slash DD slash YYYY
Is this a low income weatherization application?(Required)
Do you receive low income bill payment assistance from the PUD?(Required)

Installation Verification

Yes, this DHP has been installed on a dedicated electrical circuit.(Required)
Yes, I have installed refrigerant line protection on the entire length of exterior, insulated refrigerant lines.(Required)
Yes, I have installed the system in accordance with manufacturer specifications, including adherence to proper refrigerant charging.(Required)
Drop files here or
Accepted file types: jpg, jpeg, gif, png, pdf, heic, doc, docx, Max. file size: 128 MB.

    Installer Information

    Installer Name(Required)
    Mailing Address for Installation Company

    Installer Signature

    By signing this application, the installer certifies that this form and any accompanying documentation are complete and accurate, and that all measures associated with this project were completed as of the signature date. The signature certifies that the installer is licensed, bonded, insured, and has been trained by the manufacturer of the installed product and if installing a single head Ductless Heat Pump, has received the contractor orientation available at Comfort Ready Home. This form must be signed by the installer.

    With my signature below, I certify that I meet all of the above rebate requirements and that the information I have provided is accurate and complete.

    Clear Signature
    MM slash DD slash YYYY
    This field is for validation purposes and should be left unchanged.