Mitsubishi Electric Rebate

Fill out the form below to claim your Mitsubishi Electric Rebate.

PLEASE NOTE: Only one rebate per entry form. Each rebate must include an indoor unit AND an outdoor unit for a valid rebate.

Contractor Name(Required)

First Last

Customer Name(Required)

First Last

Customer Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of Sale(Required)

Distributor Invoice Nu.(Required)

Rebate Amount(Required)

Qualified Mitsubishi Electric Systems Sold(Required)

Model Nu.

Serial Nu.