Stowe Electric Customers who purchased a qualifying ......of this rebate. I authorize Stowe Electric...
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Date Submitted: _________________ Stowe Electric Account #__________ Account Holder’s Name: _______________________ Service Address: Mailing Address: Contact Information ___________________ ________________________ Phone:(____)______________ Stowe, Vermont ________________________ Email: ____________________ Purchase Date:_________________ Store Name and Location: ____________________________ Number of e-bicycles purchased by the account holder: _________ Did you purchase a verified Class I electric bicycle (Y/N): __________ Manufacturer: Model No.: Serial No.: 1._____________________ 1.__________________ 1.___________________ 2._____________________ 2.__________________ 2.___________________ Household Income Eligibility: Please fill out only if you meet all of the qualifications below for an income-based incentive. You might be eligible for an income-based incentive if you qualify under one of the following categories: Persons in Household 1 2 3 4 5 6 7 8 Annual Income $44,240 $50,560 $56,880 $63,200 $68,256 $73,312 $78,368 $83,424 Signature:_________________________________________ Date:____________________________ I certify that the information submitted is correct and I shall adhere to the terms and conditions of this rebate. I authorize Stowe Electric to confirm the information I submitted before receiving my rebate. Return to [email protected]. Stowe Electric Customers who purchased a qualifying electric bicycle in 2021 are eligible for a $200 rebate from Stowe Electric Department. Please see page 2 for more details or call 802-253-7215. STOWE ELECTRIC DEPARTMENT 2021 E-BIKE REBATE FORM
Transcript of Stowe Electric Customers who purchased a qualifying ......of this rebate. I authorize Stowe Electric...
Date Submitted: _________________
Stowe Electric Account #__________ Account Holder’s Name: _______________________
Service Address: Mailing Address: Contact Information
___________________ ________________________ Phone:(____)______________
Stowe, Vermont ________________________ Email: ____________________
Purchase Date:_________________
Store Name and Location: ____________________________
Number of e-bicycles purchased by the account holder: _________
Did you purchase a verified Class I electric bicycle (Y/N): __________
Manufacturer: Model No.: Serial No.:
1._____________________ 1.__________________ 1.___________________
2._____________________ 2.__________________ 2.___________________
Household Income Eligibility: Please fill out only if you meet all of the qualifications below for an income-based incentive. You might be eligible for an income-based incentive if you qualify under one of the following categories:
Persons in Household
1 2 3 4 5 6 7 8
Annual Income
$44,240 $50,560 $56,880 $63,200 $68,256 $73,312 $78,368 $83,424
Signature:_________________________________________ Date:____________________________ I certify that the information submitted is correct and I shall adhere to the terms and conditions of this rebate. I authorize Stowe Electric to confirm the information I submitted before receiving my rebate. Return to [email protected].
Stowe Electric Customers who purchased a qualifying electric bicycle in 2021 are eligible for a $200 rebate from Stowe Electric Department. Please see page
2 for more details or call 802-253-7215.
STOWE ELECTRIC DEPARTMENT 2021 E-BIKE REBATE FORM
Terms and Conditions
Offer valid for qualifying e-bicycles purchased January 1, 2021 through December 31, 2021.
This offer is only valid with Class 1 e-bikes that are limited to a top speed of 20 miles per hour and the electric motor engages only when the rider is pedaling.
You are responsible for following all rules applicable to electric bicycle use and you must independently verify you are allowed to use any e-bike on any trail, path, or road.
This rebate is available to customers of Stowe Electric and is in conjunction with other offers that might be offered at local bicycle retailers and sporting goods retailers in Stowe, Vermont and Lamoille County.
For more information: Stowe Electric: 802-253-7215, [email protected], or https://www.stoweelectric.com/programs/rebate-programs.
We will not endorse an e-bike manufacturer and limit this rebate to only Class I e-bikes as defined by State of Vermont and local regulations. We encourage you to visit a retailer in Stowe, Vermont. Or contact the Stowe Energy Committee for more information.
Customers eligible for total rebate incentives of $600 or greater must complete a W-9 form and submit a copy to Stowe Electric.
You must send Stowe Electric a copy of the invoice you received at the point of purchase.
If the model number and serial number are not provided on your invoice form, then please refer to the faceplate on your e-bike and send a picture of the faceplate attached to your rebate request.
We will contact you directly with additional information requests. Otherwise, please allow a minimum of 30 days from the date of receipt for us to mail your rebate check.
Stowe Electric reserves the right to modify or end this offer at any time.
STOWE ELECTRIC DEPARTMENT 2021 E-BIKE REBATE FORM
