Rebate Request Form
Please complete all the information in the form below to apply for a rebate. NOTE: All rebate requests must be submitted with all relevant information within 120 days of install completion date. A copy of the member's signed contract or paid receipt must accompany this application. You may attach a digital copy at the end of this form by clicking the "upload copy of receipt" button. If you need assistance submitting your receipt, please call the office at 800-537-3913 or 765-569-3133. Receipts can also be faxed to 765-569-3360 or mailed to Customer Service Dept, 119 West High Street, Rockville IN 47872.
Service Address
Mailing Address
Home Type

A copy of the member's paid receipt must accompany this application. Please upload a digital copy at the end of this form by clicking the 'upload copy of receipt' button. If you need assistance submitting your receipt, please call the office at 800-537-3913 or 765-569-3133. Receipts can also be faxed to 765-569-3360 or mailed to Customer Service Dept, 119 West High Street, Rockville IN 47872.

Heat Pump
Geothermal
Heat Pump Water Heater
One file only.
10 MB limit.
Allowed types: txt, pdf, doc, docx, ppt, pptx, odp, xls, xlsx, ods.
Incentive payment may be subject to on site verification upon discretion of Parke County REMC. It is my understanding to qualify for any air source heat pump rebates (excluding mini-split systems), I am allowing the installation of a load management switch that may be subject to operation for load reduction. I also understand if I remove or request the switch be removed, I will be billed the amount of the rebate to be paid within thirty (30) days after the switch is removed.
I understand all rebate request must be submitted with all relevant information within 120 days of install completion date.
By signing below, I certify the information provided above is true and accurate.
CAPTCHA
4 + 0 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.