Electric Outdoor Power Equipment Rebate Form
Applicant Information
Enter your Account #
First Name
Last Name
Email
Phone
How did you hear about our program?
Please select...
Flyer
Newsletter
MVEA Website
Social Media
Friends/Family
Local Organization
Contractor
Retailer
Local Organization Name
Contractor Name
Retailer Name
Service Address Information
Street
City
State Abbreviation
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
Rebate Selection
Please select the Rebate you would like to apply for
Please select...
Riding Mower
Walk-Behind Mower
Snow Blower (Single-Stage)
Snow Blower (Two-Stage)
Chainsaw
Blower
Power-Washer
Electric Bicycle
Pruner
Trimmer
Riding Mower
Product
Manufacturer
Model #
Price (do not include sales tax
$
Attach Receipt Here
Did you purchase an additional battery?
Please select...
Yes
No
Additional Batteries
Product
Manufacturer
Model #
Price (do not include sales tax
$
Connector Information - Riding Mower
Record Type Name
Application Record Type ID
Walk-Behind Mower
Product
Manufacturer
Model #
Price (do not include sales tax
$
Did you purchase an additional battery?
Please select...
Yes
No
Additional Batteries
Product
Manufacturer
Model #
Price (do not include sales tax
$
Attach Receipt Here
Attach Receipt Here
Connector Information - Walk-Behind Mower
Record Type Name
Application Record Type ID
Snow Blower (Single-Stage)
Product
Manufacturer
Model #
Price (do not include sales tax
$
Did you purchase an additional battery?
Please select...
Yes
No
Additional Batteries
Product
Manufacturer
Model #
Price (do not include sales tax
$
Attach Receipt Here
Attach Receipt Here
Connector Information - Snow Blower (Single-Stage)
Record Type Name
Application Record Type ID
Snow Blower (Two-Stage)
Product
Manufacturer
Model #
Price (do not include sales tax
$
Did you purchase an additional battery?
Please select...
Yes
No
Additional Batteries
Product
Manufacturer
Model #
Price (do not include sales tax
$
Attach Receipt Here
Attach Receipt Here
Connector Information - Snow Blower (Two-Stage)
Record Type Name
Application Record Type ID
Chainsaw
Product
Manufacturer
Model #
Price (do not include sales tax
$
Did you purchase an additional battery?
Please select...
Yes
No
Additional Batteries
Product
Manufacturer
Model #
Price (do not include sales tax
$
Attach Receipt Here
Attach Receipt Here
Connector Information - Chainsaw
Record Type Name
Application Record Type ID
Blower
Product
Manufacturer
Model #
Price (do not include sales tax
$
Did you purchase an additional battery?
Please select...
Yes
No
Additional Batteries
Product
Manufacturer
Model #
Price (do not include sales tax
$
Attach Receipt Here
Attach Receipt Here
Connector Information - Blower
Record Type Name
Application Record Type ID
Power-Washer
Product
Manufacturer
Model #
Price (do not include sales tax
$
Did you purchase an additional battery?
Please select...
Yes
No
Additional Batteries
Product
Manufacturer
Model #
Price (do not include sales tax
$
Attach Receipt Here
Attach Receipt Here
Connector Information - Power-Washer
Record Type Name
Application Record Type ID
Electric Bicycle
Product
Manufacturer
Model #
Price (do not include sales tax
$
Attach Receipt Here
Connector Information - Electric Bicycle
Record Type Name
Application Record Type ID
Pruner
Product
Manufacturer
Model #
Price (do not include sales tax
$
Did you purchase an additional battery?
Please select...
Yes
No
Additional Batteries
Product
Manufacturer
Model #
Price (do not include sales tax
$
Attach Receipt Here
Attach Receipt Here
Connector Information - Pruner
Record Type Name
Application Record Type ID
Trimmer
Product
Manufacturer
Model #
Price (do not include sales tax
$
Did you purchase an additional battery?
Please select...
Yes
No
Additional Batteries
Product
Manufacturer
Model #
Price (do not include sales tax
$
Attach Receipt Here
Attach Receipt Here
Connector Information - Trimmer
Record Type Name
Application Record Type ID
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