Residential Heat Pump Electric Resistance Verification Form

Qualified “Whole House” systems must meet or exceed 80% of the heat load of the home. Verification is based on two years of fuel use history review.

ENERGY STAR® Certified Whole House Heat Pump Incentive

Qualified “Whole House” systems must meet or exceed 80% of the heat load of the home. Verification is based on two years of fuel use history review.
Member Information(Required)
Installation Address(Required)
https://energyaudit.nhsaves.com/squarefootage
Measure every section of baseboard in the home. Add it all up. Round your total to the nearest whole foot. This will give you your total linear feet of baseboard.

Annual Heating Fuel Usage

Is electric baseboard your primary heating source? (Check one)(Required)
Please include all other heat sources. (Check all that apply)(Required)

Contractor Information

Address(Required)

Equipment Information

MM slash DD slash YYYY
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Max. file size: 16 MB.
    Must contain Install location, Make and Model Number(s), Contractor Information (Business Name, Address, Phone Email), and Total Project Cost.
    Drop files here or
    Max. file size: 16 MB.
      Drop files here or
      Max. file size: 16 MB.
        Please include all rooms in the home. (Closets not required) Location of all baseboard. Location of all (new to be installed) interior heads. Location of outside unit(s). Note: Floor plan can be hand drawn and does not have to be to scale.
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        (Required)
        MM slash DD slash YYYY