Income Qualified Rebate Program Intake Form "*" indicates required fields Do you heat your home electrically, for example with a heat pump, electric furnace or baseboard heaters?* Yes No The Income Qualified Rebate Program is only available for electrically heated homes.How many people live in your home, including adults and children?*12345678Is the total monthly income before taxes and other deductions for all people living in the home below $5,796? Include all income sources of the household.* Yes No Is the total monthly income before taxes and other deductions for all people living in the home below $6,621? Include all income sources of the household.* Yes No Is the total monthly income before taxes and other deductions for all people living in the home below $7,450? Include all income sources of the household.* Yes No Is the total monthly income before taxes and other deductions for all people living in the home below $8,275? Include all income sources of the household.* Yes No Is the total monthly income before taxes and other deductions for all people living in the home below $8,938? Include all income sources of the household.* Yes No Is the total monthly income before taxes and other deductions for all people living in the home below $9,600? Include all income sources of the household.* Yes No Is the total monthly income before taxes and other deductions for all people living in the home below $10,263? Include all income sources of the household.* Yes No Is the total monthly income before taxes and other deductions for all people living in the home below $10,925? Include all income sources of the household.* Yes No Your total monthly household income exceeds the program limits. You may qualify for our standard rebate programs. More information can be found here. Was your home built in or before the year 2000?* Yes No Based on the information you provided above, your household may be eligible for the Income Qualified Rebate Program. Please contact us at [email protected] or 360-992-3460. If you would like us to reach out to you, please enter your preferred contact information below and click submit.Based on the age of your home, the insulation levels are likely sufficient. If in doubt, please contact us at [email protected] or 360-992-3460. 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