City of Albany: Heat Pump Rebate Application
Instructions:
Please complete the application below. Homeowners may fill out the application for themselves, or contractors may fill it out on behalf of the homeowner.

**Your project must have a building permit before you fill out the application. All heat pump projects that received a permit less than 4 months before completion of the rebate application are eligible.**

After you've submitted your application, City staff will confirm your eligibility, reserve your rebate funds, and notify you. When your project is complete, you must submit your signed building inspection record and a W-9 form. The rebate funds will then be mailed to you.

Please contact Michelle Plouse at mplouse@albanyca.org or (510) 528-5754 if you have any questions or concerns.
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Contractor Information: If this form is being filled out by a contractor, please list your name, company name, and contact email below. If the form is being filled out by the property owner, please leave this question blank and skip to the property owner information below.
Property Owner Name *
Property Owner Email *
Property Owner Phone Number *
Project Address *
Property Owner Mailing Address (if different)
Does the property owner qualify as low-income or moderate-income? For more information, see the "Income Levels" section on the program webpage: https://www.albanyca.org/heatpumps
Clear selection
What type of heat pump is being installed? For more information, see the "Ducted vs ductless heat pumps" section on the program webpage: https://www.albanyca.org/heatpumps *
What is the permit number for this project? (To qualify for the rebate, you must have a City of Albany building permit issued in the last 4 months.) *
Is the electrical panel being upgraded as part of this project? *
OPTIONAL QUESTIONS

These questions are designed to help us understand the impact of this program and improve the design of future programs. We would appreciate it if you answered as many as you can!
If installing a heat pump water heater, what kind of water heater is being replaced?
Clear selection
If installing a heat pump HVAC, what kind of HVAC system is being replaced?
How old is the previous system?
What is the make and model of the heat pump being installed?
How did you hear about the City of Albany's heat pump HVAC rebate program?
Clear selection
Did you know about heat pumps before you heard about this program?
Clear selection
Would you have still installed a heat pump without this rebate program?
Clear selection
Are you receiving any other rebates for this project?
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