iZEV - Incentive received forms

Incentive Received Form for Individuals for the iZEV Program

I, (print name of individual), resident of (City), (Province/Territory), acknowledge that on the date of purchase or lease below, I received an incentive from the federal Incentives for Zero-Emission Vehicles (iZEV) Program in the amount of $ (amount of incentive applied), which is available to an eligible recipient who purchases or leases an eligible zero emission vehicle. This incentive was deducted from the final purchase price, including taxes and fees, for my new (make, model, year and trim level of eligible zero-emission vehicle), which was purchased / leased on (date of purchase or lease) at (name of dealership).

I further acknowledge that I have signed the iZEV Program Consumer Consent Form dated , and I have provided the iZEV Program Consumer Consent Form to the dealership above.

I attest that I have not received an incentive under the iZEV Program during this calendar year, other than for the purchase or lease for which this form is completed

I represent that I will not seek to receive more than one incentive under the iZEV Program in any calendar year. I understand that should I be found to have received more than one incentive from the iZEV Program in a calendar year, the dealership(s) who provided the iZEV incentive(s) may seek to recover the amount of the incentive provided to me. I further represent that I will not seek to claim the proposed enhanced federal capital cost allowance for zero-emission vehicles announced in the 2019 federal budget for any vehicle for which I have received an iZEV incentive.


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Incentive Received Form for Organizations for the iZEV Program

I, (print name of individual), of (City), (Province/Territory), acting as an authorized representative and on behalf of (name of organization) (the “Organization”), which operates in (City), (Province/Territory), acknowledge that on the date of purchase or lease below, the Organization received an incentive from the federal Incentives for Zero-Emission Vehicles (iZEV) Program in the amount of $ (incentive amount), which is available to an eligible recipient who purchases or leases an eligible zero-emission vehicle. This incentive was deducted off the final purchase price, including taxes and fees, for the Organization’s new (make, model, year and trim level of eligible zero-emission vehicle), which was purchased / leased on (date of purchase or lease) at (name of dealership).

I further acknowledge that I have signed the iZEV Program Consumer Consent Form dated , and provided the iZEV Program Consumer Consent Form to the dealership.

I, (name of authorized representative), am authorized to make the following declarations on behalf of the Organization:

  • that the Organization has not received more than 10 incentives under the iZEV Program this calendar year, including the purchase(s) or lease(s) for which this form is completed;
  • that should the Organization be found to have received more than ten incentives from the iZEV Program in a calendar year, the Organization agrees that the dealership(s) who provided the iZEV incentive(s) may seek to recover the amount of the incentive(s) provided to the Organization; and
  • that the Organization cannot seek to claim the proposed, enhanced federal capital cost allowance for zero-emission vehicles announced in the 2019 federal budget for any vehicle for which the Organization has received an iZEV incentive.


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