Member-Purchased Home Level 2 Charger Form

Record Type Name

Application Record Type ID

Please complete this form and send it to VEC with proof of purchase of a qualifying Level II charger to receive a $250 bill credit.

Participants who accept this incentive must do one of the following:

1) If ChargePoint or Emporia, enroll in a communications platform so that VEC can request that your charger not operate during peak events (5-6 events per month for 3-4 hours each). A VEC representative will contact you to complete this process, and you will receive an additional $50 incentive for enrolling as well as $8/month if you do not opt out of individual events, OR

2) Set your charger or car schedule to not charge from 5 - 10pm Mon-Fri and send in a screenshot on that schedule.

Participants also will be enrolled in VEC’s Beat the Peak Program, where members receive alerts about 3-4 events during the summer when VEC expects high demand for electricity. During these events, VEC requests that members take steps to decrease their electric use, such as shutting lights off, turning up the thermostat, and delaying use of major appliances.

Contact Information

Account #

First Name

Last Name

Phone

Service Address Information (Charger will be sent here unless you provide an alternate mailing address)

Street

City

State Abbreviation

Zip Code

Is your Service Address same as your Mailing Address?

YesNo

Mailing Address (Where to send the charger, cannot be a PO Box)

Street

City

State Abbreviation

Zip Code

Would you like to enroll in the communications platform or set a schedule on your charger or vehicle?

Enroll in communications platform (charger must be ChargePoint or Emporia)Set a schedule to avoid charging 5 - 10 pm Mon - Fri

Make and Model of Charger

Information needed for the next question. The next question is required for VEC to comply with state reporting guidelines and does not affect your eligibility for the incentive.

Household income is gross wages (i.e. pre‐tax) from all sources of income from individuals who are considered part of your household.

Chittenden, Franklin or Grand Isle County

1 person: $72,700

2 person: $83,100

3 person: $93,500

4 person: $103,850

5 person: $112,200

6 person: $120,500

7 person: $128,800

8 person: $137,100

Addison County

1 person: $65,050

2 person: $74,350

3 person: $83,650

4 person: $92,900

5 person: $100,350

6 person: $107,800

7 person: $115,200

8 person: $122,650

All other counties

1 person: $62,550

2 person: $71,500

3 person: $80,450

4 person: $89,400

5 person: $96,550

6 person: $103,700

7 person: $110,850

8 person: $118,000

Based on your county and household size, was your 2024 household income at or below the level in the chart above?

YesNo

Email or phone number where you would like to receive Beat the Peak alerts?

Please upload a copy of the invoice or receipt for the charger.

Please upload an image of the car or charger schedule set to avoid charging 5 - 10pm Monday-Friday.

This information may be shared with state regulators and their contractors for program evaluation. By submitting this form, you agree to allow VEC to share this information with regulators for program evaluation.

I agree