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EV Fast Charger Rebate Form

Complete the form below to claim your rebate on a Level 2 electric vehicle fast charger. Rebates are subject to fund availability. The following requirements apply:

1)  You must be an electric customer of Mount Horeb Utilities

2)  Attach copy of EV charger invoice

3)  Attach copy of charger installation invoice  

Residential Customers

$250 rebate per Level 2 charger (a maximum of 50% of installed cost not to exceed $250)

Commercial Customers

$1,000 rebate per Level 2 or 3 charger (a maximum of 50% of installed cost not to exceed $1,000)

$1,500 rebate per Level 2 or 3 dual-head charger (a maximum of 50% of installed cost not to exceed $1,500)

Customer Information

Provide customer name as shown on Mount Horeb Utilities bill.
Commercial customers only

Charger Information

$
Files must be less than 5 MB.
Allowed file types: gif jpg jpeg png pdf.
$
Files must be less than 5 MB.
Allowed file types: gif jpg jpeg png pdf.

Vehicle Information

Confirmation

I understand that this offer provides a $250 incentive ($1,000 or $1,500 for Commercial) for a Level 2 EV charger at a residence or business currently receiving electricity on a retail basis from Mount Horeb Utilities. Mount Horeb Utilities makes no warranties, expressed or implied, with respect to any equipment purchased and/or installed including, but not limited to, any warranty of merchantability or fitness for purpose. In no event shall Mount Horeb Utilities be liable for any incidental or consequential damages. I understand that this program has a limited budget, and that applications will be accepted on a first-come, first-served basis, until allocated funds are spent. This program may be modified or discontinued at any time without notice. I certify that all statements made in this application are correct to the best of my knowledge and agree to Mount Horeb Utilities conformation visit of installed EV charger. I agree to the terms and conditions of this offer as set forth on this application.