7310 West Morris Street
Indianapolis, IN 46231
Ph. 800.428.4326
Manufacturer’s Certification Statement

Ductless Heat Pump System

The below identified packaged product with a natural gas or propane furnace contains an advanced main air circulating fan that has an annual electricity use of no more than 2 percent of the total annual energy use of the furnace as determined in the standard Department of Energy test procedures (AMACF) and qualifies for the tax credit allowed under Section 25C of the Internal Revenue Code.

The make and model number of the packaged product, the installation date, and the portion of the installed cost of the furnace attributable to the cost of the AMACF (listed as a superscript), are as follows:

Make: Payne
Install Date: ______________________
Dealer to select one box indicating product size and orientation 1 The cost attributable to the AMACF is irrelevant with respect to furnaces purchased and installed after 12/31/10.

A taxpayer claiming a credit for Residential Energy Property Expenditures should retain this certification statement and the receipt of purchase as part of the taxpayer’s records and should consult with a tax professional to determine eligibility for and application of the credit(s)..

Under penalties of perjury, I declare that I have examined this certification statement, and to the best of my knowledge and belief, the facts presented are true, correct, and complete.

David Meyers
V.P., Sales