Consumer Instant Rebate Program
Armstrong Dealer Information
Submitted by
*
First Name
Last Name
Submitter Email
*
example@example.com
Company Name
*
G.W. Berkheimer Account #
*
Branch Location
*
Please Select
001-Gary
002-Indianapolis
003-Evergreen Park
004-South Bend
005-Arlington Heights
006-Fort Wayne
007-Lombard
008-Tinley Park
009-Valparaiso
010-Fishers
011-Lafayette
012-Aurora
013-McHenry
014-Louisville
015-Rockford
016-Niles
017-Cicero, Berwyn
018-Elkhart
019-Elgin
020-Joliet
021-Crown Point
022-Peru
023-Warsaw
Dealer Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Tier Level
*
Standard
ComforTeam
ProTeam
Equipment Type
*
Please Select
Furnace/Air Handler
Air Conditioner
Heat Pump
System
Furnace/Air Handler Type
*
Please Select
A98MV(K)
A97MV
A972V(K)
A802V(K)
7AH2AV
A972E(K)
7AH1AV
Heat Pump Type
*
Please Select
4SHP22LX
A7HP19V
A7ACP21V
Air Conditioner Type
*
Please Select
A7AC22V
What type of System did you purchase?
*
Furnace/Air Handler & Air Conditioner
Furnace/Air Handler & Heat Pump
Select your Furnace/Air Handler & Air conditioner System
*
Please Select
A98MV(K) - A7AC22V
A98MV(K) - A7AC14F
A97MV - A7AC22V
A97MV - A7AC14F
A972V(K) - A7AC22V
A972V(K) - A7AC14F
A802V(K) - A7AC22V
A802V(K) - A7AC14F
7AH2AV - A7AC22V
7AH2AV - A7AC14F
A972E(K) - A7AC14F
7AH1AV - A7AC14F
Select your Furnace/Air Handler & Heat Pump System
*
Please Select
A972E(K) - A7HP19V
A972E(K) - A7SCP18V
7AH1AV - A7HP19V
7AH1AV - A7SCP18V
A98MV(K) - A7CP21V
A98MV(K) - 4SHP22LX
A98MV(K) - A7HP19V
A98MV(K) - A7SCP18V
A97MV - A7CP21V
A97MV - 4SHP22LX
A97MV - A7HP19V
A97MV - A7SCP18V
A972V(K) - A7CP21V
A972V(K) - 4SHP22LX
A972V(K) - A7HP19V
A972V(K) - A7SCP18V
A802V(K) - A7CP21V
A802V(K) - 4SHP22LX
A802V(K) - A7HP19V
A802V(K) - A7SCP18V
7AH2AV - A7CP21V
7AH2AV - 4SHP22LX
7AH2AV - A7HP19V
7AH2AV - A7SCP18V
Furnace/Air Handler Model Number
*
Furnace/Air Handler Serial Number
*
Air Conditioner Model Number
*
Air Conditioner Serial Number
*
Heat Pump Model Number
*
Heat Pump Serial Number
*
Air Handler Model Number
*
Air Handler Serial Number
*
Furnace/Air Handler Credit Amount
$225
$200
$175
Air Conditioner Credit Amount
$225
Heat Pump Credit Amount
$200
$225
Furnace/Air Handler & AC Credit Amount
$375
$400
$425
$450
$500
$525
$550
Furnace/Air Handler & Heat Pump Credit Amount
$400
$425
$450
$500
$525
$550
Homeowner Information
Homeowner Name
*
First Name
Last Name
Homeowner Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Homeowner Email
example@example.com
Installation Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Installation Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
GWB Invoice No.
*
The highlighted section of the image above is the section you enter into this field.
Attach GWB Invoice
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
GWB Invoice No.
*
The highlighted section of the image above is the section you enter into this field.
Attach GWB Invoice
*
Browse Files
Drag and drop files here
Choose a file
You can attach multiple documents here
Cancel
of
Please attach dealer invoice with proof of rebate given to the homeowner and G.W. Berkheimer Invoice
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Calculate Furnace Estimated Credit Amount
Yes
No
Estimated Furnace/Air Handler Credit Amount
Calculate Air Conditioner Estimated Credit Amount
Yes
No
Estimated Air Conditioner Credit Amount
Calculate Heat Pump Estimated Credit Amount
Yes
No
Estimated Heat Pump Credit Amount
Calculate Furnace/Air Handler & Air conditioner Estimated Credit Amount
Yes
No
Estimated Furnace/Air Handler & Air conditioner Credit Amount
Calculate Furnace/Air Handler & Heat Pump Estimated Credit Amount
Yes
No
Estimated Furnace/Air Handler & Heat Pump Credit Amount
Print
Submit
HQ Use Only
Area
Credit Amount
Invoice No.
Credit Memo #
Credit Memo Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Contractor Rebate Issued
Amount Claimed
Should be Empty: