DEVELOPER SUBDIVISION HEAT PUMP DISTRIBUTION PAYMENT REQUEST                          


Please fill out the information below and submit this online form, it will be directly emailed to the appropriate person. Items with a * are required in order to submit the request.

If you prefer to send in a request for payment, please fill out this form and fax to 816-556-2221 or mail to: Kansas City Power & Light, c/o Dist. Request 1201-13, PO Box 418679, Kansas City, MO 64179-0031.

DEVELOPER INFORMATION
*Requestor First Name:
*Requestor Last Name:
*Phone:
*Dev Company Name:
*Dev Company Address:
*City:
*State:
*ZIP:
Check issued to
(if different than above):
SUBDIVISION INFORMATION
*Subdivision Name:
*Location:
HP Agreement # (NBS#):
Lot # Address Amount
DATA SUBMIT
By submitting this request I certify that the residences listed above have completed heat pump installations that are in accordance with my Heat Pump Subdivision Agreement.

     © 2008 Kansas City Power & Light Company
     Kansas City, Missouri