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New Construction for EV Ready Home Rebate

Date

Member Account Information

First

Last

Account Number

Map Location

Member Type

If rebate is to be issued to homeowner, please indicate homeowner's first and last name.

If account is listed under the builder's name, do you want the rebate to be issued to the new homeowner?

Yes, Issue rebate to new homeowner

Contact Information

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Phone Number

Daytime Phone Number

Participation Agreement

I agree to the terms of the program rebate program.

E-signature for EV ready home rebate program

Sign above

Electric Vehicle Ready Wiring Information

Is home EV ready? (Check one.)

Yes

Submit picture to verify installation of EV ready wiring.

One file only.
20 MB limit.
Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, txt, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, svg.

Electrician Name/City:

Do you/new homeowner have immediate plans to purchase an EV or install a Level 2 charger?

Yes

Unknown

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