Level 2 Electric Vehicle Charger Rebate Application

Qualifying Level 2 (240-volt) Electric Vehicle chargers must be:

ENERGY STAR certified
New and not used, resold, or rebuilt
Certified by Underwriters Laboratories Inc. (UL Listed)

Current Rebate Amount

$200 per charger (limit one rebate per charger and one per residence)

EQUIPMENT INFORMATION

Asterisks (*) indicate required fields.

Charger Manufacturer*

Charger Model Number*

Date of Installation (or purchase date)*

Enter charger's date of installation. If not yet installed, enter date of purchase.

CAR INFORMATION

Electric Vehicle Make*

Electric Vehicle Model*

UPLOAD YOUR REBATE DOCUMENTATION

Provide a copy of your purchase receipt or invoice for the Level 2 EV Charger showing:

Model number
Manufacturer
Date of purchase
Cost

Provide a photo of the charger and car connected.

File Upload*

Max. file size: 20 MB.

APPLICANT INFORMATION

Account Number

Name*

First Last

Are you the account holder?*

Yes

No

Relationship to the Account Holder*

Family Member

Landlord

Tenant

Other

Phone*

Email*

Enter Email Confirm Email

Residence Type*

Site Built Home (4 units or less)

Multi-Family Home (5 units or more)

Manufactured Home

New Construction

Multi-Family Type*

Low Rise (5 units or more, 3 stories or less)

Mid/High Rise (6 units or more, 4 stories or less)

Installation Address*

Street Address City State ZIP Code

Do you have a different mailing address?*

My mailing address is the same as above

I have a different mailing address

Mailing Address*

Street Address City State ZIP Code

Application Notes

Please insert any notes that you would like us to review with your application. (This is not required to submit the application.)

SUBMIT YOUR APPLICATION

By submitting this form, the applicant acknowledges that they have read and agree to the utility's Terms & Conditions found at the bottom of this page.

*

I agree to the Terms & Conditions

Please allow 8 to 10 weeks after receipt of all required documentation for rebate checks to be issued. Rebates under $100 will be automatically credited to your account.

Rebate Terms & Conditions

Rebates
Residential Rebates
Non-Residential Rebates
Agriculture
- New Pump Efficiency Upgrade
- Variable Frequency Drive (VFD)

Brought To You By

Conservation Partner

Contact Us

For more information regarding rebates or energy efficiency please call us at 888-883-9879 or email us at rebates@esgroupllc.com.