Efficiency Maine EV Rebate Dealer Reimbursement Form

For EVs purchased from a Maine Participating Dealer

This form is to be completed by a Maine Participating Dealer only.

Use this form to request reimbursement for a rebate already issued or to apply for a hold for a future rebate. Rebates must be submitted within 60 days of purchase/lease. All rebates except those issued to qualifying low-income Mainers must be submitted before 5:00 pm ET on December 16, 2024.

To expedite processing, please upload individual documents to each required field. Efficiency Maine will review, and reserves the right to audit, all information and records submitted with this form. 

“*” indicates required fields