Wheatland Electric New Electric Vehicle Purchase Rebate Application

Please make sure to complete the application and attach a dated purchase invoice

New Electric Vehicle Purchase Rebate Form

Application must be submitted within 60 days of installation. Incomplete applications will not be accepted. For questions, contact Caitlin Moser, member services coordinator, at 620-874-4505 or rebates@weci.net..

MEMBER INFORMATION

Name

Email

Phone

Physical Address

Mailing Address

City/Town

State/Province

ZIP/Postal Code

Wheatland Account Number

Primary Charging Location

EQUIPMENT INFORMATION

Vehicle Type

Date of Purchase

Vehicle Make

Vehicle Model

Charger Type

VIN

Invoice

Please attach a copy of the dated receipt or contractor invoice that details all installed equipment information, including brand, model #, and serial #.
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.

APPLICANT ACKNOWLEDGEMENT

Member Signature

Please use your mouse (or finger for touch screens) to sign. By signing your name in this box, the Member affirms that the information reflected here is accurate to the best of his or her knowledge and that falsification or reporting of incorrect information on this form is grounds for denial of the rebate.

Notice:

Alert:

New Electric Vehicle Rebate

New Electric Vehicle Purchase Rebate Form