Mass Save Whole-Home Heat Pump Verification Form
This file contains the verification form for whole-home heat pump installation under the Mass Save program. It outlines eligibility criteria, customer information, and necessary acknowledgments. This form is essential for applications and rebates related to energy-efficient heat pump systems.
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How do I fill this out?
Filling out this form requires gathering your customer information and account numbers. Ensure that your heat pump meets the eligibility criteria outlined in the document. Carefully read the acknowledgments and certifications before signing off on the form.

How to fill out the Mass Save Whole-Home Heat Pump Verification Form?
1
Gather customer and sponsor information including account numbers.
2
Confirm that your heat pump installation meets the eligibility criteria.
3
Check the appropriate acknowledgments and conditions.
4
Select the project information relevant to your installation.
5
Sign and date the form to finalize your submission.
Who needs the Mass Save Whole-Home Heat Pump Verification Form?
1
Homeowners seeking energy-efficient heating solutions.
2
Contractors participating in the Mass Save installer network.
3
Real estate agents working with homeowners on energy efficiency.
4
Utility companies promoting heat pump programs.
5
Landlords looking to improve heating efficacy in rental properties.
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What are the instructions for submitting this form?
To submit this form, send it via email to rebates@masssave.com or fax it to 800-123-4567. Alternatively, you can submit it through the online portal on the Mass Save website. For physical submissions, send the completed form to Mass Save Program, 123 Energy Lane, Springfield, MA 01101. Ensure all fields are filled out accurately for a smooth processing experience.
What are the important dates for this form in 2024 and 2025?
Ensure that all forms are submitted between January 1, 2024, and December 31, 2025, to qualify for the Mass Save rebates. Specific eligibility dates may vary depending on installation and inspection schedules. Always check the Mass Save website for the latest updates on important dates.

What is the purpose of this form?
The purpose of this form is to verify the installation of heat pumps for residential customers. It serves as a record for eligibility in the Mass Save rebate program. This verification ensures that participants meet all necessary requirements for energy efficiency initiatives.

Tell me about this form and its components and fields line-by-line.

- 1. Customer Information: Includes fields for the account holder's name, address, contact details, and email.
- 2. Eligibility Criteria: Specifies requirements such as heat pump capability and pre-existing systems.
- 3. Acknowledgments: Requires customer to certify the accuracy of the information provided.
What happens if I fail to submit this form?
Failure to submit this form may result in denied rebates or delays in the installation process. It's crucial to provide complete and accurate information to avoid potential issues.
- Denial of Rebate: Incomplete submissions will lead to the denial of any rebates applied for.
- Delayed Processing: Missing information can slow down the overall processing time of your application.
- Future Eligibility Impact: Inaccurate or misleading information may affect your eligibility for future programs.
How do I know when to use this form?

- 1. New Installations: Use this form for new heat pump installations to apply for rebates.
- 2. System Upgrades: Submit when upgrading from an older system to a more efficient heat pump.
- 3. Rebate Applications: This form is essential for processing rebate applications for energy efficiency.
Frequently Asked Questions
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You can easily download your completed form by clicking the download button after editing.
What if I need help while filling out the form?
For assistance, you can refer to the Mass Save website or contact customer service directly.
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What happens if I don't complete the form?
If the form is incomplete, it may result in delays or denial of your rebate request.
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