EV SURVEY FORM

PERSONAL DETAILS

NAME:

PHONE:

EMAIL:

PLEASE TICK TO CONFIRM

TICK TO CONFIRM:

I have off street parking such as driveway/garage/allocated space

My vehicle is on the eligibility list

I have taken keepership or have ordered an EV, or have been assigned a company vehicle

I have not previously claimed an OZEV EVHS grant

I acquired my vehicle after October 2016

PLEASE ATTACH CLEAR PHOTOS OF:

GAS BONDING:

WATER BONDING:

FUSEBOX/CONSUMER UNIT:

MAIN FUSE/CUTOUT & METER:

PARKING SPACE:

PROPOSED LOCATION OF EVC:

CABLE ROUTE:

NAME:

PHONE:

EMAIL:

MESSAGE: