IRA Home Energy Rebates

Multifamily Income Qualification Form

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Public housing authorities and private landlords with multifamily buildings must complete this application to apply for income qualified incentives from IRA Home Energy Rebate programs. For assistance, call 800.762.7077.

Ownership Information

Rental Property Ownership *

Housing Authority

Privately Owned

Address & Contact

Primary Address *

Street Address

Street Address Line 2

City

State / Province

Postal / ZIP Code

Mailing Address is different from Primary Address

Contact Name *

Title *

Phone Number *

Email *

Income approval award letter will go to this email.

Building / Site Information

What type of property is this? *

Multifamily In-Unit— A single unit in a multifamily building applying for the rebate.

Multifamily— Shared building upgrades that benefit all units in a multifamily building.

Multifamily Site Address(es) *

No addresses added yet. Click "Add Address" to begin.

Utility Information

Electric Utility Provider *

Electric Account Number

Primary Heating Fuel *

Tenant Information & Proof of Eligibility

Are you income qualifying the entire building or by individual tenants?

Entire Building (categorical eligibility)

Individual Tenants

Signature

Privately Owned Building Eligibility Declaration

By signing below, I certify that the information provided in this application is true and accurate to the best of my knowledge, and I acknowledge the program terms and conditions.

I have read and agree to the eligibility declaration and program terms. *

Signature *

Sign here with your finger or mouse

Full Name (printed) *

Date

I verify that I have read and agree to the IRA Home Energy Rebates Program Terms & Conditions.