Ecodiesel settlement claim form 2026

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Click ‘Get Form’ to open the ecodiesel settlement claim form in the editor.
Begin with SECTION A: NAME AND CONTACT INFORMATION. Fill in your first name, last name, mailing address, email address, and telephone number. Ensure all details are accurate as this is where your settlement check will be sent.
Move to SECTION B: VEHICLE INFORMATION. Select your eligible vehicle model and year by checking the appropriate box. Enter the 17-digit Vehicle Identification Number (VIN) clearly to avoid any errors.
Indicate your status of ownership or lease by selecting one of the provided options. Fill in the dates of ownership or lease period as required.
In SECTION C: SUPPORTING DOCUMENTATION, ensure you attach all necessary documents based on your ownership status. This may include vehicle registration, proof of purchase, or lease agreements.
Finally, complete SECTION D: CERTIFICATION STATEMENT by signing and dating the form to affirm that all information is true and accurate.

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