California HEEHRA Mini Split Application.

This application is for existing owner occupied California homes installing a ductless mini split heat pump system.

Full Name

Phone *

Email *

Address

City

State

Current Heating Type *

Is your Current Heating System Opreational? *

Yes

I confirm this is an existing owner occupied home? *

Yes I confirm

Income Qualification

Eligibility must be verified before project approval can be requested.

Automatic qualification if someone in the household recieves,

Important notice: SSA retirement benefits alone do not qualify. SSA award letters are not accepted.

Upload your Proof of active enrolment *

If no one recives the program above,

Upload your 2024 IRS form 1040. *

Only the full 2024 1040 is accepted. W2 forms, pay stubs, or partial returns can not be processed.

Rebate reservation and approval must occur before installation.

By Submtting this application you confirm that you are ready to proceed with the installation upon approval *

Yes I confirm

No I don’t

I understand installation cannot begin before program approval. *

Yes, I understand

No, I don’t

I authorise LivSmart to share required project information with program administrators for processing. *

Yes, I understand

No, I don’t