For EVs purchased directly from a manufacturer
Use this form to request a reimbursement (for a vehicle already purchased) or a rebate hold (for a vehicle on order that won’t be delivered until a later date).
This form is for vehicles purchased directly from a manufacturer. If you are a Participating Dealer submitting a reimbursement request, please use this form.
This form is to be completed within 45 days of the transaction by the EV Purchaser who purchased or leased an eligible EV directly from the vehicle manufacturer and not through a licensed, franchised dealer in Maine (see Efficiency Maine Electric Vehicle Accelerator Program Manual, Section 8 for more information). The purchase or lease must be on or after August 29, 2019.
All fields must be completed and all documentation must be valid. Efficiency Maine will review, and reserves the right to audit, all information and records submitted with this form. All required forms and documents can be found on the Electric Vehicle Rebates page under “EV Rebate Program Forms and Documents”.
Note that the EV Purchaser must have received an income verification letter from Efficiency Maine before purchasing the vehicle to receive an enhanced rebate amount (e.g., rebates for low- and moderate-income individuals). See the Electric Vehicle Rebates page for details.
Vehicle must have a price of no more than the amounts listed below, where the price is defined as total manufacturer’s suggested retail price (MSRP) or “sticker price”, including options and accessories, before destination/delivery charges, and no other discounts, deductions, credits or rebates are to be counted in the eligibility determination calculation:
- $73,000, in the case of an eligible pickup truck or commercial van with an EPA-rated range of 300 miles or more;
- $65,000, in the case of an eligible pickup truck or commercial van with an EPA-rated range of less than 300 miles; or
- $50,000, for all other eligible vehicles
For vehicles that have been ordered with a paid deposit but will not be delivered until a later date, the Purchaser may use this form to request a “rebate hold”. A rebate hold allows Efficiency Maine to reserve funds for the rebate(s) for 120 days or until the purchase is completed, whichever comes sooner. See Efficiency Maine Electric Vehicle Accelerator Program Manual, Section 8.2 for more information on rebate holds.
If you’d prefer to send your rebate application by mail, you can request a printable version of this application by calling (866) 376-2463 and asking for the Electric Vehicles team.