How to Apply

If you meet the terms and conditions below, please complete this application and send it together with
the required documentation to:

LADWP Used EV Rebate Program

P.O. Box 51111, Room 1019
Los Angeles CA 90051-0100

Section 1: Required Documentation Checklist

The following documents must be submitted by all applicants:

 Complete, original, signed, and dated rebate application

 Copy of current DMV registration
 Copy of the bill of sale, as filed with the DMV, showing the Applicant as the buyer of the
EV for which a rebate is requested

Proof of residence:

 Signed rental or lease agreement, or utility bill (telephone, cable or satellite

television not older than three months from the date of the application)
 If the registered owner of the Qualifying EV is not identified in the proof of
residence, the person identified in the proof of residence must sign Section 5 -
Affidavit of the application

SECTION 2: Applicant and Property Information

Please check either box to indicate if:

 Your residence (house, apartment, condominium, etc.) has an active LADWP meter.
 Your residence (house, apartment, condominium, etc.) does not have an active LADWP
meter, but the building in which your residence is located does.
If your residence or the building in which it is located does not have an active electric meter served by
LADWP you are not eligible for the program.

Applicant Name________________________________
First and last name of the applicant. If your DMV registration shows two owners, only one of the two owners can
apply.

Applicant Address ______________________________

Permanent residence address (no PO box). The building in which your residence is located must have an active
electricity meter served by LADWP. If your mailing address is different, use the section below.
 Unit # _________________________________
City ___________________________________
ZIP Code _______________________________
Mailing Address________________________________
(If different from your residence)

Unit # _________________________________
City ___________________________________
ZIP Code _______________________________
Day Time Phone Number ________________________
Alternate Phone Number ________________________
Optional

Email ________________________________________
Please be sure to include your email address to receive updates about your application

Residence Type:
 Single Family Residence
 Multi-family Residence (including apartment, condominium, and townhouse)
 Mobile Home
 Other: ____________________

If your residence (house, apartment, condominium) has an LADWP electric meter, please provide the
following information:

LADWP Account Name____________________

Include account holder name as it appears on the utility bill for your residence. You do not have to be an
LADWP account holder to apply for the rebate.

LADWP Account Number __________________

Section 3: Vehicle Information

17-Character Vehicle Identification Number (VIN) __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

As shown on your DMV registration.
Make ________________________________________
Model _______________________________________
Model Year ___________________________________
Purchase Price _________________________________
Amount you paid to the vehicle’s seller.

Other Financial Incentives _______________________

Financial incentives, including third party rebates you received for the vehicle

Net Cost______________________________________

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Actual cost you paid for the vehicle (Purchase Price - Other Financial Incentives)

Section 4: Terms and Conditions

1. The LADWP Used Electric Vehicle Rebate Program provides rebates applicable against the cost
of purchasing a qualifying used electric vehicle or plug-in hybrid electric vehicle. The Program
begins on April 1, 2018, and expires on March 31, 2021. The Program may be modified without
prior notice and terminated when the Program goals are met, or funds are exhausted;
whichever comes first. Applications are accepted on a first-come, first-served basis and are
processed in the order received.
2. The maximum rebate offered is $450 for the purchase of a qualifying used electric vehicle or
plug-in hybrid electric vehicle as defined below. The final rebate will be based on the total cost
of the vehicle paid by the applicant, minus any other EV financial incentives or rebates received
from third parties. The maximum rebate of $450 shall not exceed the total cost of the Qualifying
EV. Only one used EV rebate is available per vehicle. For example the next owner of the used
vehicle after DWP issues a rebate under the Program will not be eligible to claim a rebate.
3. Eligible applicants are limited to LADWP residential customers and their household members, as
well as tenants and residents living permanently at a residential property with an active electric
meter served by LADWP. Eligible applicants may only receive a single rebate under the program
regardless of the number of Qualifying EVs purchased.
4. The Qualifying EV must be:
- An operational four-wheel on-road electric vehicle registered with the DMV, DOT
approved for highway application, and listed on www.DriveClean.ca.gov/PEV. Golf carts,
neighborhood carts, motorcycles, and electric scooters are not Qualifying EVs under this
Program.
- Purchased on or after April 1, 2018,
- Registered with the California Department of Motor Vehicles (DMV) at the address
provided in this application in the name of the applicant. Leased or rented vehicles (or
any other form of possession where the applicant is not identified as the owner by the
DMV) or vehicles received as family transfers, gifts and prizes do not qualify for a rebate
under the program.
- A model at least 2 years older than the calendar year in which the applicant applies for a
rebate under the Program. For example if an applicant submits an application in 2018,
the Qualifying EV must be a 2016 model or older as shown on the DMV registration.
5. Eligible Applicants must submit a completed application with an original signature (not copied)
along with all required documentation to LADWP by U.S. mail as follows:
- Copy of current DMV registration for the Qualifying EV
- Proof of residence (including signed rental agreement or utility bills such as telephone,
cable or satellite television not older than three months from the date of the
application) showing an Eligible Address. If the registered owner of the Qualifying
vehicle is not identified in the proof of residence, the person identified in the proof of
residence must sign Section 5 - Affidavit of the application, and

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 - Copy of the bill of sale as filed with the DMV, showing the Eligible Applicant as the buyer
of the Qualifying EV.
6. The application must be postmarked no later than March 31, 2021. Only applications with an
original signature will be accepted. Faxed, scanned, or emailed applications WILL NOT be
accepted. Applications received by LADWP that are missing required support documentation, or
that do not meet any other Program requirements will be considered ineligible for a rebate.
LADWP is not responsible for documents lost or destroyed in the mail via transit or misdirected
applications. Submitted rebate applications and accompanying documents become the property
of LADWP and will not be returned.
7. LADWP reserves the right to inspect the Qualifying EV at any time with reasonable notice.
Eligible Applicants agree to provide LADWP’s representative reasonable access to the Qualifying
EV during normal business hours at the address shown in this application and on the DMV
registration. Any refusal by Eligible Applicants to allow reasonable access to the Qualifying EV
for the purpose of inspection by an authorized LADWP representative may result in forfeiture of
the rebate.
8. The City of Los Angeles and LADWP make no warranties and are not responsible for any
representations, whether expressed or implied, including, but not limited to, the warranty of
merchantability, fitness for a particular use product performance and useful life, or application
of the item(s) or measure(s) manufacturers, dealers, contractors, or any other third parties,
materials, workmanship, the quality, safety and/or installation of the item(s) or measure(s),
effects on pollutants or any other matter with respect to the Program.

Section 5: Agreement and Certification

I understand, and agree with the terms, conditions and requirements of the LADWP Used EV Rebate
Program. I certify that the information I have provided is true and correct and the vehicle for which I am
requesting a rebate meets the requirements of this program.

Applicant Signature _____________________________

Applicant First and Last Name (please print) _________

Date _________________________________________

Section 6: Affidavit

If the proof of residence (signed rental or lease agreement or utility bill) you submit as part of the required
documentation is not in your name, the tenant (shown on the rental or lease agreement) or utility account holder
(shown on the utility bill you submit) must fill out and sign this section.

I, (first and last name) ____________________, reside at _________________________ .

I am (check one):

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  The tenant identified in the lease or rental agreement for the residence listed in this
application, or
 The owner of the residence listed in this application.

I hereby certify that the Applicant, (first and last name) _______________ , permanently
resides at the address provided in this application.

Signature ____________________________________

Day Time Phone Number ________________________

Alternate Phone Number ________________________

Email ________________________________________

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