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VT E-Bike Dealer Voucher Submission Form - 2024

Introduction

Vermont eBike Dealer Voucher Submission Form

Thank you for being a participating retailer in the State of Vermont eBike Incentive Program. Per the Retailer Participation Agreement terms, please submit the following information within 30 days of a voucher being redeemed.

Please have the following information available to complete this submission form (acceptable file formats for uploading: png, gif, jpg, jpeg, pdf, doc, docx):
  • Sales Receipt. If the consumer’s name is not listed on the Sales Receipt, other sales documentation should be provided with the application. The sales receipt must include the following information:
    • Sales Date
    • Sale Price (before tax)
    • eBike Make
    • eBike Model
    • eBike Serial Number/Unique ID (if applicable)
    • Applied incentive amount
Please click next to begin your submission form.