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Get City Of Corona Afvrp Form

City of Corona Public Works Department Alternative Fuel Vehicle Rebate Program AFVRP Application 400 South Vicentia Avenue Corona CA 92882 Name Telephone Home Telephone Mobile Address Zip Code Email Address A copy of the dated bill of sale/purchase contract shall be attached rebates do not apply to leases. 6. What is the average round trip miles of your daily work commute mile per day 7. Will this vehicle be used for your daily work commute Check Box to Confirm I have read understand and agree to the AFVRP eligibility requirements and limitations I agree to complete an annual vehicle use survey to assist the City of Corona in qualifying emission reductions achieve through this vehicle purchase. Please complete the following information* Failure to provide the requested information may result in process delays or denial of the rebate. Vehicles may be subject to inspection* Vehicle Information Make Model Model Year Vehicle Identification Number VIN Dealer/Broker Information Representative Date of Vehicle Purchase Check Correct Box 1. Is the vehicle new 2 000 rebate or used 1 000 rebate New Used 2. Will this be your primary vehicle Yes No 3. Was a trade-in used to purchase this vehicle - if yes complete the table below Trade-In Vehicle Information Mileage on vehicle at trade-in 4. Approximately how many miles per year do you currently drive mile per year 5. Estimate the number of miles planned for this vehicle each year. I certify that I or any one in my household have not received a rebate through this program within the last 36 months. Please complete the following information* Failure to provide the requested information may result in process delays or denial of the rebate. Vehicles may be subject to inspection* Vehicle Information Make Model Model Year Vehicle Identification Number VIN Dealer/Broker Information Representative Date of Vehicle Purchase Check Correct Box 1. Vehicles may be subject to inspection* Vehicle Information Make Model Model Year Vehicle Identification Number VIN Dealer/Broker Information Representative Date of Vehicle Purchase Check Correct Box 1. Is the vehicle new 2 000 rebate or used 1 000 rebate New Used 2. Will this be your primary vehicle Yes No 3. Is the vehicle new 2 000 rebate or used 1 000 rebate New Used 2. Will this be your primary vehicle Yes No 3. Was a trade-in used to purchase this vehicle - if yes complete the table below Trade-In Vehicle Information Mileage on vehicle at trade-in 4. Was a trade-in used to purchase this vehicle - if yes complete the table below Trade-In Vehicle Information Mileage on vehicle at trade-in 4. Approximately how many miles per year do you currently drive mile per year 5. Estimate the number of miles planned for this vehicle each year. Please complete the following information* Failure to provide the requested information may result in process delays or denial of the rebate. Vehicles may be subject to inspection* Vehicle Information Make Model Model Year Vehicle Identification Number VIN Dealer/Broker Information Representative Date of Vehicle Purchase Check Correct Box 1. Is the vehicle new 2 000 rebate or used 1 000 rebate New Used 2. Will this be your primary vehicle Yes No 3.

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