Member Account Information
First Name
Last Name

Contact Information
Service Address
Rate Selection
Participation Agreement
Sign above using your finger or mouse to write your signature.
Electric Vehicle Information
One rebate per account.
Select the type of EV and corresponding rebate:
Is your EV purchased (or leased) and registered with DMV at service address above?
A copy of proof of purchase/invoice and documentation verifying equipment purchase must be included.
One file only.
100 MB limit.
Allowed types: gif, jpg, png, svg, pdf, png, jpeg, .
Home Charging Equipment

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