Thank you for your participation in the Golden State Rebate Program. We are on pause until Nov. 1, 2025.
On Nov. 1, 2025, you will again be able to submit for rebates through this portal.

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Customer Data Intake Form

Eligibility Requirements:

INSTALLERS/PURCHASERS: Please review the full Terms & Conditions, and confirm each
of the program requirements before proceeding:

Terms & Conditions

✔ This purchase is for a residential retrofit project (New Construction is not eligible)

✔ The end-use customer is a Pacific Gas & Electric (PG&E), Southern California Edison (SCE),
San Diego Gas & Electric (SDG&E), or SoCalGas (SCG) customer in California

✔ For a fuel substitution replacement, the end-user must receive electricity service from
PG&E, SCE, or SDG&E

✔ I'm replacing a Gas Storage or Electric Storage tank

✔ Propane Storage and Tankless replacements are not eligible.

✔ I know, or I�m able to, acquire the homeowner�s email address and phone number

** All fields are REQUIRED and must be ACCURATE.

** Do not use: Characters (e.g. �&�) use �and� instead

** Do not use: All Caps (PLUMBING) use �Plumbing� instead

** Do not use: Inaccurate Inputs such as (None, N/A, Skip, etc.)

End Use Customer Information
End User Customer First Name:
End User Customer Last Name:
End User Customer Email:
End User Customer Phone Number:
Project Intake Information
Building Type:
Existing Equipment Type (equipment being replaced):
Existing Equipment Size
Are you installing more than one water heater in this single-family home?
*Propane Storage and Tankless water heater replacements are NOT eligible for the Golden State Rebates at this time*
Replacement (NEW) Water Heater Tank Size:
*Once selected, if you need to make changes to the �Replacement (NEW) Water Heater Tank Size� dropdown you will need to refresh the webpage before proceeding*
Purchasing From: (Choose Distributor/Wholesaler)
End User Customer's Utility:
*Once selected, if you need to make changes to the �End User Customer's Utility� dropdown you will need to refresh the webpage before proceeding*
Customer Installation Location Information
Installation Address:
Installation City:
Installation Zip Code
Estimated Installation Date:
Installation Contractor Information
Installation Contractor Business Name:
Installation Contractor First Name
Installation Contractor Last Name
Installation Contractor Address
Installation Contractor City
Installation Contractor Zip Code
Installation Contractor Phone Number:
Installation Contractor Email:
Distributor Invoice Number:
	T&C: By checking the box, I am confirming that I accept the Terms and Conditions of the Golden State Rebates Program.

** All fields are REQUIRED and must be ACCURATE.

** Do not use: Characters (e.g. �&�) use �and� instead

** Do not use: All Caps (PLUMBING) use �Plumbing� instead

** Do not use: Inaccurate Inputs such as (None, N/A, Skip, etc.)

If you have any questions, please contact the program at (866) 258-4937 or email listed below.

Email: info@goldenstaterebates.com