EPA CLEAN
SCHOOL BUS
2023 EPA Clean School Bus Rebate Forms:
Close Out Form User Guide
March 2026
United States
Environmental Protection
* W -i Agency
EPA-420-B-26-006
-------
Table of Contents
Before You Begin 4
1. Sign In/Register 5
2. Applicant Information 5
2.1 Start a New Close Out Form 5
2.2 Welcome 6
2.3 Information Icons and Mandatory Fields 6
2.4 Applicant Information 6
2.5 Saving and Editing Your Information 7
3. School District Information 8
4. Add Organizations 9
4.1 Organization Information 10
4.2 Add Documents 12
4.3 Add Document Information 13
5. Bus Information 15
5.1 Swap or Exclude a Bus 15
5.2 Existing Bus Information 17
5.3 New Bus Information 19
5.4 Complete Bus Information 25
6. Infrastructure Information 26
6.1 Add Infrastructure—Level 2/Direct Current (DC) Fast Chargers 27
6.2 Add Infrastructure—Other Eligible Infrastructure Costs 30
7. Funding Information 32
7.1 Bus Funding Allocations 32
7.2 Infrastructure Award Allocations 34
8. Build America, Buy America Compliance 37
9. Telematics 39
-------
10. Signature 40
10.1 Missing Document or Organization Information 41
11. Next Steps 42
Appendix A: Glossary 43
Appendix B: Printable List of Fields 55
41
-------
Before You Begin
This guide will walk you through the steps needed to create, edit, submit, and view the Close Out Form for
your 2023 Clean School Bus (CSB) rebate. This guide also includes detailed definitions of key fields found in
the online Form and a printable list of all fields required in the Form. Plan to spend eight or more hours
to complete the Close Out Form. You do not need to complete it in one session: you can save the Form and
come back at any time.
Follow these steps to prepare for completing the Close Out Form.
1. Confirm the point of contact. Confirm that the email of the person that plans to complete the Close
Out Form is registered as a designated Government Business (or Alternate) or Electronic Business (or
Alternate) Point of Contact (POC) in your organization's active SAM.gov entity registration. Otherwise,
the person will not be able to access the rebate application system. For more information regarding
SAM.gov POCs, please see the "Who Can Submit a Rebate Application?" section of the CSB Rebate
website.
2. Review the glossary of terms in Appendix A.
3. Compile all required data. Appendix B provides a printable list of all necessary data fields.
4. Check the browser version. Before filling out the Close Out Form, make sure the web browser
version meets or exceeds the following versions:
— Chrome 38
— Safari 7.1
— Internet Explorer 11
— Firefox 13
Note: The sections in this guide follow the order in which you will complete the Close Out Form. There is also
a Glossary section that defines terms and abbreviations to reference while going through this guide and the
online Form.
Ik
-------
1. Sign In/Register
Use your existing SAM.gov credentials to log in to your Clean School Bus Rebate Forms applicant dashboard.
If you are unable to sign in, please refer to the 2023 CSB Rebate Application User Guide for instructions on
how to update your SAM.gov information.
2. Applicant Information
2.1 Start a New Close Out Form
After signing in to your applicant dashboard, you will see the "Clean School Bus Rebate Forms" dashboard.
Select 2023 in the Rebate Year drop-down menu.
Clean School Bus Rebate Forms
• Clean School Bus Rebate Program
• Online Rebate Application Information
Rebate Year: 2023 v
New Application
t
Select the New Close Out button to begin.
Your Rebate Forms
Select« button bekwrlo fdit or Hew ^c
• For thf 2022 i»bat« year, you «Ji5s, j wfthdr*ttal, or a Clow Qui Form |*m C • OjI Form nvrbp.ijif'J by smatling c
# ftwbata ID
• fwTypt
§ ttxm suui
Payment fegutsr
• DEI
* fM lndil*lnr
l?J4S6»Oi£3
1234
# Apf»(ks«i
# ithop. a
6 Updated By
# D«t* Updated
# Ch«ni.i ftaqunt
Ch^ffcK
chw a
Q Mm Chx* Oul
Mote: Your connection to the Close Out Form system will time out unless you interact with the screen at least
once every 15 minutes. " Interacting" can mean entering or deleting information or even moving your cursor on
the screen. If your connection times out, you risk losing data entered since the last save. It is best practice to
select the Save button at the bottom of the page each time you enter additional information.
-------
2.2 Welcome
Review the text on the "Welcome" page to determine what information you will need and how to complete
the Close Out Form, then select Next at the bottom of the page to proceed.
Note: Use of the browser back, forward, or refresh buttons while in the Close Out Form will result in loss of
work. Please navigate using the Next, Previous, and Save buttons located at the bottom of the Form page.
2.3 Information Icons and Mandatory Fields
Hover your mouse over the information icons (i.e., circles with question marks), which are found throughout
the Close Out Form pages, for more information and instructions on specific fields.
Mandatory fields that are editable are marked with a "*" to the right of the field name. Unless otherwise
denoted, these fields must be completed before proceeding to the next page or selecting a Complete button
on a page.
Some fields are mandatory to complete before the Close Out Form can be submitted to the EPA but can be
left blank as you move through the Close Out Form. Look for this message below these fields, "This field
is mandatory to complete the Close Out Form but is not required to complete and save the [page name]
information." For these fields, you may save your work and navigate to other sections or pages to update or
add missing information and then return to the field to complete it.
2.4 Applicant Information
The "Applicant Primary Contact" and "Applicant Alternate Contact" information fields will prepopulate with
information from the associated Payment Request Form. Double-check that your primary and alternate
contact information is correct. To update the contact information for the primary contact, select "Update
Primary Contact" and update the relevant field(s). To replace the primary contact with a different person,
select "Replace Primary Contact" and provide the new contact's name, title, phone number, and email
address. Follow the same steps to update or replace the alternate contact. You can also add a new alternate
contact if no alternate contact was provided on the Payment Request Form. Select Next to continue. Note:
The Applicant Primary and Alternate Contact fields can only be updated one at a time. If you choose to either
replace or update Primary or Alternate contact by mistake, you must uncheck the selection box to select the
other option.
123456000111
Unique Entity Identifier (UE!) Q
Applicant Primary Contact
]) Update Primary Contact O Replace Primary Contact 0
Ik,
-------
2.5 Saving and Editing Your Information
You can save your work while filling out the Close Out Form and return to it later to finish and submit. Data
entered on each page will be saved automatically when the Next button is selected. In addition, you can use
the Save button to save information before proceeding to the next page.
^ NOTE: Use of the browser back, forward, or refresh buttons will result in loss of work. Please navigate using the buttons at the bottom of the form.
When you click Next or Save, a box will pop up in the top right corner of your screen confirming your
information has been saved.
_LJ J
@ Draft saved successfully.
Note: You will lose work if you use your browser's back, forward, or refresh buttons while in the Close Out
Form. Instead, navigate using the Next and Previous buttons.
After saving and exiting the Close Out Form, you can return to the "Clean School Bus Rebate Forms" screen
later. Open the "draft" form by selecting the Edit button and proceed by navigating to where you left off.
Selecting forms with a "Submitted," "Funding Approved," or "Selected" status will allow you to view, but not
edit, your entries.
Additionally, you can submit a change request for any form that has been created. The Change Request Form
allows you to edit, extend, or withdraw a form depending on its status.
Application
© Selected
123456000111
1234
9/11/2025
Change B •
Payment Request
© Funding Approved
Change 13
Close Out
••• Draft
1/8/2026
Change 03
-------
3. School District Information
The "School District General Information" and "School District Prioritization Information" sections of this page
will prepopulate based on the National Center for Education Statistics (NCES) District ID entered on your
application or later updated through a school district change request. These two sections are not editable in
the Close Out Form and can only be updated through a school district change request approved by the EPA. If
the school district change is approved, the updated school district will replace the original school district. If the
Close Out Form is in an "Edit Requested" status or if the approved new school district is not correctly listed,
please select Refresh School District Information. If the new school district information is not populating
correctly, please email the CSB Helpline at cleanschoolbus@epa.aov.
© of 11 School District Info
This is the school district that the new replacement buses will serve for at least five years. The School District General Information and School District Prioritization Information is based on
the NCES District ID you entered on your application form and is not editable here. If the school district that the new replacement buses serve needs to be changed, the request for change
must be approved by EPA utilizing the Change Request form for this rebate. If needed, you can update the School District Contact Information below.
* denotes required field
Refresh School District Information
0 To change the school district that replacement school buses will serve for the next five years, you must send an email to cleanschootbusiffiepa.gov with the email subject
being, "School District Change", the type of request, the NCES ID for the new school, the new school name, and contact person (including first name, last name, title,
business email, and business phone number), when replacing a school district with another one, the district must be in the same state and have the same school district
prioritization or higher.
School District General information
National Center for Education Statistics (NCES) District ID
School District Name City
Physical Address Line 1 State or Territory
Physical Address Line 2 Zip Code
School District Prioritization Information
Prioritized O
Yes
Priority Reason Q
Q High Need Q Tribal Q Rural
Are you self-certifying as prioritized? #
Double-check that your school district contact information is correct. To update the contact information, select
Update School District Contact and edit the relevant field(s). To replace the school district contact with a
different person, select Replace School District Contact and provide the new contact's name, title, phone
number, and email.
Select Next to continue.
Ek
-------
4. Add Organizations
Review the information on this page to understand the types of organizations for which you will need to
provide information. Required organizations include the entity(ies) that took control of the existing bus(es), the
owner(s) and dealer(s) of the new bus(es), and owner(s), supplier(s), new bus service provider(s), electrification
as a Service (EaaS) provider(s), and installer(s) of electric bus charging infrastructure, if applicable.
Select + Add Organization to proceed.
of 11 Organizations
This page is for adding organization information for existing buses, new buses, private fleets, infrastructure, and telematics. Organizations that you entered in your Application and Payment
Request forms are already included on this page. Here you can update organizations already entered, or enter new organizations. For each organization that you add by selecting the "+Add
Organization" blue box. you'll need to select the organization type(s) and then enter the name, contact and address information for the organization. Information for each organization only
needs to be entered once, even if the organization applies to multiple buses or infrastructure, or multiple organization types. It is strongly recommended that you add all the organizations
that are associated with this rebate at this time to avoid having to return to this page later. The following organization types can be entered on this screen:
• Scrap Yard (existing bus): Any organization that scrapped an existing bus.
• Donee (existing bus): Any organization that received a donated existing bus from the applicant.
• Purchaser (existing bus): Any organization that purchased an existing bus from the applicant.
• Existing Bus Owner: All existing bus owners. If the existing bus owner is the applicant, the school district that the new buses will serve, or a private fleet entered in your application or
Payment Request form, then you do not have to enter existing bus owner information as it's already included within this form.
• New Bus Owner: All the new bus owners (e.g. district, nonprofit, private fleet, tribes). If the new bus owner is the applicant, the school district that the new buses will serve, or the
private fleet entered in your application or Payment Request form, then you do not have to enter new bus owner information as it's already included within this form.
• Private Fleet (existing or new buses): Any private fleet for existing or new buses that is not the applicant needs to be entered here unless you already entered the private fleet(s) in your
application, or Payment Request form. Selectees may list multiple private fleets here.
• New Bus Dealer: The vendor or dealer that the new bus owner purchased the bus from needs to be identified.
• New Bus Service Provider: An organization that provides new buses and other services to new bus owners through a service agreement.
• Infrastructure Owner (electric bus charging): All infrastructure owners (e.g. school district, private fleet) of the electric bus charging equipment needs to be identified. If the
infrastructure owner is the applicant, the school district that the new buses will serve, or a private fleet entered in your application or Payment Request form, then you do not have to
enter new bus owner information as it's already included within this form.
• Infrastructure Supplier (charging equipment only): All infrastructure suppliers from which charging equipment was purchased (includes the installer of the infrastructure charging
equipment when they are also the charging equipment supplier).
• Electrification as a Service (EaaS provider): An organization that provides charging services through a service agreement.
• Infrastructure Installer: Organization that installs structures and equipment (e.g. trenching, vehicle pads, and wiring that excludes charger installers when the charger is installed by
the infrastructure charging equipment supplier) that are part of the eligible CSB rebate.
• Other Infrastructure Organization: All other eligible Infrastructure organizations that are not a infrastructure installer, supplier, or owner (e.g. project management, design, and
permitting only).
• Telematics Contact (optional): The organization responsible for supplying bus and EVSE telematics data to EPA or its partners for participation in research.
On the documents, buses, infrastructure (if applicable), and telematics pages you will be selecting organizations you entered here or in your application for each document, bus and
infrastructure owner, supplier, or organization.
" denotes required field
Organizations
Organization
1
Org. Name; School Bus Sales
Type: New Bus Dealer
Contact Name: Mary Bus
Address: 1234 Street, City, Alaska
+ Add Organization
-------
4.1 Organization Information
Select an organization type by checking the appropriate box(es). If a single organization serves multiple roles,
enter the organization once and check all applicable boxes for Organization Type.
Organizations
Organization (»
1
General Information
Organization Type * G Organization Name Q *
Q Scrap Yard (existing bus) | NewBusOwne>|
~ Donee (existing bus)
~ Purchaser (existing bus)
~ Existing Bus Owner
¦ Q New Bus Owner
~ Private Fleet (existing or new buses)
~ New Bus Dealer
~ Infrastructure Owner (electric bus charging)
~ Infrastructure Supplier (charging equipment only)
~ Infrastructure Installer
~ Other Infrastructure Organization
I | Telematics Contact
t
Review the requirements for each organization in the informational text at the top of this page (Page 4 of the
Form). Take note of the organization types that do not need to be included on this page if they are already
entered as the applicant organization or school district
Once you select an organization type(s), enter the organization's name, address, and contact information. If
the organization was included in the Payment Request Form, then the "Address" and "Contact Information"
sections are prepopulated from the Payment Request Form but can be edited as necessary
Address
Organization Address 1 Q *
Organization City Q *
1234 Street
City
Organization Address 2 Q
Organization State or Territory Q *
Alaska x "
Organization County O *
Organization Zip Q *
County
12345-
Contact Information
Update Organization Contact
| Change This Contact to Another Person
Organization Contact First Name Q *
Mary
Organization Contact Last Name O *
Bus
Organization Contact Title Q *
Manager
Organization Contact Business Email Q *
mbus@sales.org
Organization Contact Business Phone Number i
(123) 456-7890
-------
When ail fields have been entered for the organization, select the Complete button.
Note:This button does not save your form. You must select the Save or Next buttons to save your information.
\
Contact Information
Update Organization Contact
Organization Contact First Name Q *
Mary
Organization Contact Last Name Q *
Bus
Organization Contact Title Q *
Manager
Complete
) Change This Contact to Another Person
Organization Contact Business Email Q *
mbus@sales.org
Organization Contact Business Phone Number O *
(123) 456-7890
+ Add Organization
Add another organization by selecting +Add Organization at the bottom of the page. You may add as many
organizations as needed and delete or edit them at any time. Note that deleting an organization is permanent,
so do not do so unless you are sure it is necessary. You must select the Complete button at the bottom of the
"Organizations" page before moving on.
If you select Complete before all required rows are filled out, the missing field(s) will appear in red.
Address
Organisation Address 1 O "
Organization City 4) *
1.234 Str**t
City
Organization Address 2 ©
Organization State or Territory Q *
Coloirado * 1
Organization County O *
Organization Co unty is required
Organization Zip Q *
12345
Once you have added all of your organizations, select Next to continue.
-------
4.2 Add Documents
On this page, you will add information about new buses and any infrastructure. This information includes
uploading all final invoices and proof of delivery documents for both buses and infrastructure. Select + Add
Document to begin.
Note: Documents for propane and compressed natural gas (CNG) infrastructure are not needed, as
their infrastructure is not eligible for rebate funding. Documents should only be uploaded for buses and
infrastructure that were purchased with CSB rebate funds.
^^ofll Documents
On this page you will need to enter a description of and upload the following documents:
• Final invoices Final invoices for all new buses and infrastructure. For each invoice, indicate whether it includes bus(es), electric bus charging equipment, or other infrastructure
installation costs by clicking on the applicable checkboxes under Document Purpose. Purchasers and vendors associated with each invoice must be selected as well. You can also select
whether an invoice applies to all buses and/or infrastructure and this information will be automatically added to the Buses and/or Infrastructure pages.
• Proof of delivery for all new buses and infrastructure (e.g., bill of lading with delivery date). DO NOT upload photos showing old bus scrappage, new buses, or charging pedestals here as
those should be uploaded on the Bus and/or Infrastructure pages of this form. Purchasers and vendors associated with each proof of delivery must be selected as well. You can also
select whether a proof of delivery applies to all buses and/or infrastructure and this information will be automatically added to the Buses and/or Infrastructure pages.
' denotes required field
Documents
Document
1
Type: Final Invoice
Purpose: Electric Bus Charging Equipment
Document Name: Test Document
Vendor: School Bus Sales
Note:
+ Add Document
Delete
EEk
-------
4.3 Add Document Information
The fields in the screenshot below appear after you select + Add Document.
i
Document Information
Document Name Q *
Document Description 4
Test Document
Document Purpose (Choose all that apply) * Q
Q New Bus
Q Electric Bus Charging Equipment
Q Other Infrastructure Installation Costs
Apply Final Invoke to all buses
Apply Final Invoice to all charging infrastructure
Apply Final Invoice to all other infrastructure
Document Type Q '
Associated Purchaser Q "
Contact Name:
Associated Vendor 4
Org. Name: School Bus Sales | Contact Name: Mary Bus
Document Upload © '
File Name
Test Oocument-Ddf
Allowed file types: ".pdf, *.prsg, ".jpeg. *.jpg
Minimum file size: 1KB
Maximum file size: 5MB
Enter the document name. Make sure each document's name is unique; it will be used to refer to the
document elsewhere in the Form. You can also enter a description, but it is not required. Select the document
purpose by checking the box(es) that apply Next, select a document type, either final invoice or proof of
delivery, using the drop-down menu. Select the associated purchaser and associated vendor from the drop-
down list. The options in the drop-down menu are the organizations you added on Page 4 of the Close Out
Form. If you do not see the organization you need to select, then select the Return to Organizations Page
button at the bottom of the page and add the organization's information there.
Return to Organizations Page
Return to Bus Information Page
Return to Infrastructure Page
I •
NOTE: Use of the browser back, forward, or refresh buttons will result in loss of work. Please navigate using the buttons at the bottom of the form.
Before uploading a bus invoice, verify that it includes the following information:
¦ Manufacturer
¦ Model
¦ Model year
-------
¦ Fuel type
¦ Vehicle Identification Number (VIN)
¦ Gross Vehicle Weight Rating (GVWR)
¦ Total cost of each bus
¦ Date of delivery; if the bus invoice does not contain the date of delivery, please ensure that the proof
of delivery document includes the date of delivery, e.g., delivery receipt, or bill of lading.
¦ Dealer/vendor letterhead
Before uploading an infrastructure invoice, verify that it includes the following information:
¦ Date of equipment delivery; if the infrastructure invoice does not contain the date of delivery, please
ensure that the proof of delivery document includes the date of delivery, e.g., delivery receipt, or bill of
lading.
¦ Vendor information (business name, phone, address, email address)
¦ Charger model, make, model year
¦ Quantity of pedestals
¦ Itemized list of services performed (if applicable)
¦ Itemized list of supplies used for installation services (if applicable)
The proof of delivery document must show the shipping company information and the date of delivery. (For
example, a dated bill of lading would qualify.)
Next, upload a PDF or image of each invoice and proof delivery document(s) outlined immediately above.
The information you enter on the Close Out Form must match the information on the bus and infrastructure
invoices and proof(s) of delivery. If necessary, please create multiple infrastructure line items to appropriately
state the eligible cost of infrastructure as stated in submitted invoices.
If you are uploading an invoice and it includes all the buses purchased, all the charging infrastructure
purchased, or all the other infrastructure purchased, select the Apply Final Invoice to all buses. Apply
Final Invoice to all charging infrastructure, and Apply Final Invoice to all other infrastructure buttons
as applicable. If you are uploading a Proof of Delivery document and it includes all the buses purchased or all
the charging infrastructure purchased, select the Apply Proof of Delivery to all buses and Apply Proof of
Delivery to all charging infrastructure buttons as applicable.
Next, select the Complete button for the document. (Note that this button does not save your form; you must
select the Save or Next button to save your information.)
You can add another document by selecting + Add Document at the bottom of the page. You may add as
many documents as needed and delete or edit them at any time. (Deleting a document is permanent, so do
not do so unless you are sure it is necessary.) Select the Complete button at the bottom of the page before
moving on.
+ Add Document
Return to Organizations Page Return to Bus Information Page Return to Infrastructure Page
I ®
NOTE: Use of the browser back, forward, or refresh buttons will result in loss of work. Please navigate using the buttons at the bottom of the form.
-------
5. Bus Information
Review the instructions at the top of the "Buses" page to identify the information needed to complete the
fields on this page.
General Information
Number of School Buses in Current Fleet Q * Number of Electric School Buses in Current Fleet Q *
Enter the total number of school buses in your current fleet and the number of electric school buses within
your current fleet. For example, if you have 10 buses in your current fleet and 5 of them are electric, enter "10"
in Number of School Buses in Current Fleet and "5" in Number of Electric School Buses in Current Fleet.
The buses listed in the "Bus Information" section are the existing buses that were entered on your Payment
Request Form. If the bus information is incomplete, you will see a message in red next to the bus number.
Select the Edit button next to each bus in the list to complete any missing information as necessary.
Bus Information
Bus
1
Existing Bus VIN: 12423523523523231
Existing Bus Fuel Type. Diesel
New Bus Fuel Type. Electric
0 Bus Information Incomplete
Click the "Edit" button lor this row, and
complete all required fields.
Bus Existing Bus VIN; 23523523545454444
2 Existing Bus Fuel Type: Diesel
New Bus Fuel Type; Propane
Select Edit to enter information about the existing and new buses.
5.1 Swap or Exclude a Bus
At this point, you can swap out existing buses or exclude buses from your fleet. Swap Existing Bus indicates
that you would like to scrap, sell, or donate a different bus from the bus you listed to scrap, sell, or donate on
your Payment Request Form. Exclude Bus indicates that you no longer want to replace a bus you listed on
your Payment Request Form with a new bus. If you do not intend to swap or exclude an existing bus, do not
check these boxes and continue completing fields that are editable in the "Existing Bus Information" section.
Existing Bus Information
^ Swap Existing Bus O Q Exclude Bus ®
Q Bus Information Incomplete
Click the "Edit" button foe this row. and
complete all required fields.
-------
if you are swapping out an existing bus for a different existing bus, select a reason for swapping the existing
bus from the drop-down menu. Note that if you select "Other" in the drop-down menu, then you will need to
provide a reason in the text field for swapping out the existing bus. Next, choose the existing bus owner from
the drop-down menu. If you do not see the owner, select Return to Organization Entry to add them. Then,
you will need to complete the "Existing Bus Information" and "New Bus Information" sections.
If you choose to exclude a bus, the EPA must be reimbursed for the maximum eligible rebate for this bus
plus any shipping or Americans with Disabilities Act (ADA)-compliance costs you received for that bus. The
reimbursement required for the maximum eligible rebate for this bus will be displayed on the "Funding" page
of the Form, and any ADA-compliance or shipping costs that you received a rebate for on an excluded bus will
be displayed on the "Buses" page.
A warning will pop up with the amount of money you will owe to the EPA. Importantly, note that the Bus
ADA and Shipping Reimbursement Owed to EPA field is only the amount owed for the shipping or ADA-
compliance portion of your rebate. The total amount owed will be reflected on the "Funding" page of the
Form. The EPA will provide information on how to reimburse the funds when you submit your Close Out Form.
Q Warning - Rebate Amount Refund Required
Excluding a bus from the Close Out Form, or changing the bus information in a way that reduces the eligible rebate amount, after
receiving a rebate may require a refund back to the EPA. Additional actions will be necessary after submittal and review of the
Close Out Form to settle this balance.
Bus ADA and Shipping Reimbursement Owed to EPA 0 $30,000.00
Rebate Owed to EPA from Bus Exclusion or Rebate Reduction Q $320,000.00
Note: If you accidentally select Swap Existing Bus or Exclude Bus, select Cancel at the bottom of the "Bus
Information" section and your data will be restored.
EEk
-------
5.2 Existing Bus Information
The data fields associated with existing buses are listed below, with required fields marked with asterisks.
Select Complete after entering your information. For field definitions that are prepopulated from the Payment
Request Form, see the 2023 Clean School Bus Rebate Forms: Payment Request User Guide.
Bus Information
I Bus - 0
Existing Bus Information
| Swap Existing Bus 0
0 Exclude Bus 0
Existing Bus Owner 0
Org Name:
Contact Name:
This field is mandatory to complete the Close Out Form but is not required to complete and save the bus information.
Existing Bus VIN 0
lilllllliilllllli
Existing Bus Fuel Type 0
Diesel
Existing Bus GVWR 0
31.000
Existing Bus EPA Vehicle Family 0
Existing Bus Odometer 0
abcdsgsdfd
50.000
ExistingBus Manufacturer 0
Other
ExistingBus Manufacturer (Other) 0
lbs Bus Co.
ExistingBus Model 0
Model
Existing Bus NCES District ID 0
Existi ng Bus Model Year 0
2000
Existing Bus Average Annual Fuel Consumption 0
5,000
Existing Bus Average Annual Mileage 0
20.000
Estimated Remaining Life ©
gal 5
Existing Bus Annual Idling Hours 0
mi 500
Replacement Process (
5c rapped
Scrap Yard Organization 4
Org. Name; Scrap Yard j Contact Name: Scrap Yard
This field is mandatory to complete the Close Out Form but is not required to
complete and save the bus information.
Existing Bus Proof of Scrappage, Sell, or Donation 0
File Name Size
Drop files to attach, or browse
Allowed file types: *.pdf, *.png, ".jpeg, *.jpg
Minimum file size: 1KB
Maximum file size: 5M8
1. The Existing Bus Owner* field requires you to choose the organization that owned the bus before
replacement. If you do not see the owner in the drop-down menu, select Return to Organization
Entry to add them.
2. Existing Bus Vehicle Information Number (VIN) is prepopulated from the information in the Payment
Request Form and is not editable.
-------
3. Existing Bus Odometer (miles)* needs to be populated with the odometer reading of the existing
bus at the time of scrappage, donation, or sale. If the exact reading is unknown, provide an estimate.
4. Existing Bus NCES District ID is prepopulated with the school district ID from the Payment Request
Form and is not editable.
5. Existing Bus Fuel Type is prepopulated from the information in the Payment Request Form and is not
editable.
6. Existing Bus Model is prepopulated from the information in the Payment Request Form and is not
editable.
7. Existing Bus Fuel Type is prepopulated from the information in the Payment Request Form and is not
editable.
8. Existing Bus Manufacturer is prepopulated from the information in the Payment Request Form and is
not editable.
9. Existing Bus GVWR is prepopulated from the information in the Payment Request Form and is not
editable.
10. Existing Bus ModelYear is prepopulated from the information in the Payment Request Form and is
not editable.
11. Existing Bus EPA Vehicle Family* needs to be populated with the 12-character alphanumeric EPA
Vehicle Family name or the 10-to-12-character California Air Resources Board (CARB) Executive
Order ID.
a. To identify the EPA Vehicle Family, refer to the Vehicle Emission Control Information (VECI) label
of the existing bus. Do not refer to an invoice for the vehicle family name of an existing bus. The
VECI is usually on or near a door pillar or on the engine compartment sheet metal.
i. Vehicle Family information is also available at the EPA website but should only be used
if the VECI label is missing on the existing bus: visit the Certification Data Spreadsheets
page, download "Heavy-Duty Vehicle Certification Data (Model Years: 2015- Present)," and
search the spreadsheet for your bus model. You may also use the "Archive (Model Years"
1982 - 2016)" data that are listed within the Certification Data Spreadsheets page.The first
letter of the EPA Vehicle Family represents the model year; see the EPA's page on Vehicle
Family naminc for a list of letters and model years.
b. If the bus is not an EPA-certified vehicle, enter the CARB Executive Order ID.
c. If the vehicle does not have EPA or CARB certification, contact the Clean School Bus helpdesk.
12. Existing Bus Average Annual Fuel Consumption is prepopulated from the information in the
Payment Request Form and is not editable.
13. Estimated Remaining Life is prepopulated from the information in the Payment Request Form and is
not editable.
14. Existing Bus Average Annual Mileage is prepopulated from the information in the Payment Request
Form and is not editable.
15. Existing Bus Annual Idling Hours is prepopulated from the information in the Payment Request Form
and is not editable.
-------
16. Replacement Process* requires you to specify how the existing bus was replaced (scrapped, sold, or
donated). Model year 2010 and older buses can only be scrapped. Model year 2011 and newer buses
can be scrapped, sold, or donated. If you sold or donated the existing bus to a scrapyard, please state
that the bus was scrapped rather than sold or donated.
17. If the existing bus was scrapped, the Scrap Yard Organization* field will appear. Select the scrap
yard from the drop-down menu (in some cases, your own organization may have completed the bus
scrappage). Next, upload the following documents for the Existing Bus Proof of Scrappage, Sale, or
Donation:
a. Photographs of the destroyed engine and chassis rail for each scrapped bus.
i. Each photo must be clearly labeled with the last four digits of the bus VIN, either on the
photo itself or in the file name.
ii. See Appendix C of the Program Guid( for example scrappage photos.
iii. Allowed file types: *.pdf, *.png, *.jpeg, *.jpg
Minimum file size: 1 KB
Maximum file size: 5MB
b. A letter signed by a representative of the scrap yard or other entity that performed the
scrappage that:
i. Lists the VINs of the bus(es) that was (were) scrapped.
ii. Affirms the date(s) that the bus(es) was (were) scrapped.
iii. Details the method of scrappage (which must align with the requirements outlined in the
).
iv. Lists contact information for the entity that performed the scrappage. See Appendix D of
the 2023 Clean School Bus Program Guide for a template of a scrappage letter that fleets
can use.
18. If the existing bus was sold or donated, then the Existing Bus Sold To or Existing Bus Donated To*
field will appear. Select the organization that the bus was sold or donated to from the drop-down list.
a. If the organization does not appear in the drop-down menu, return to the "Organizations" page
by selecting Return to Organization Entry near the bottom of the page and enter the required
information. Note: To avoid losing any information for this bus, complete the remainder of the
fields for the existing and new bus and select the "Complete" and "Save" buttons.
b. If the existing bus was sold or donated, you must submit either the receipt of sale or receipt of
donation within the Close Out Form in the Existing Bus Proof of Scrappage, Sale, or
Donation field.
5.3 New Bus Information
1. The options for New Bus Owner* are generated from the entries on the "Organizations" page with an
organization type of "New Bus Owner'.'The drop-down options also include the selectee and the school
district. If the organization does not appear in the drop-down menu, return to the "Organizations" page
by selecting Return to Organization Entry (see note below) and enter the required information.
-------
2. The options for [Mew Bus Service Provider are generated from the entries on the "Organizations"
page with an organization type of New Bus Service Provider. If the organization does not appear in
the drop-down menu, return to the "Organizations" page by selecting Return to Organization Entry
(see note below) and enter the required information.
3. Proof of Delivery* are generated from the entries in the "Documents" page with a document type of
"Proof of Delivery" and a document purpose of "Bus." If the document does not appear in the drop-
down menu, return to the "Documents" page by selecting Return to Document Entry (see
note below).
4. The options for Final Invoice* are generated from the entries on the "Documents" page with a
document type of "Final Invoice" and a document purpose of "Bus." If the document does not appear
in the drop-down menu, return to the "Documents" page by selecting Return to Document Entry
(see note below) and enter the required information.
5. New Bus Dealer is prepopulated with the vendor associated with the final bus invoice. If it is incorrect,
you will need to go back to the "Documents" page and select the Final Invoice that needs edits.Then,
update the Associated Vendor field within order document and select the "Complete" followed by the
"Save" button to save the changes made.
Note: To avoid losing any information for this bus when returning to the previous pages to complete
add information, complete the fields for the new bus and select the "Complete" and "Save" buttons.
6. New Bus Purchase Price* is the purchase price of the ordered replacement bus including tax and
any eligible training/consulting/warranty line item expenses associated with the individual bus in the
invoice. The number in this box should exactly match the expenses associated with this individual bus
in the final invoice. Do not include ADA or shipping cost for the bus or charging infrastructure costs
here. ADA cost or approved shipping cost must be on a standalone line item within the invoice, and
infrastructure costs will be detailed later in the Form.
New Bus Information
New Bus Owner o
Org Name: Private Fleet | Contact Name:
This field is mandatory to complete the Close Out Form but is not required to
complete and save the bus information.
New Bus Service Provider o
Org Name: Not Applicable | Contact Name:
This field is mandatory to complete the Close Out Form but is not required to
complete and save the bus information.
Proof of Delivery Q
Document #: 2 | Document Name: delivery
Document Description: delivery
This field is mandatory to complete the Close Out Form but is not required to
complete and save the bus information.
Bus Rebate Amount Received
$345,000.00
Maximum Eligible Bus Rebate from Close
Out Form O
$345,000.00
New Bus Purchase Price Q *
$345,000.00
Document #: 11 Document Name: Final Invoice
Document Description: invoice
This Field is mandatory to complete the Close Out Form but is not required to
complete and save the bus information.
New Bus Dealer Q
-------
7. Enter the 17-digit ViN for the bus delivered for New Bus VIN*. Each bus should have a unique VIM,
If two or more buses with the same VIN (either within this rebate or through another CSB funding
program) are listed for replacement, a yellow warning banner will appear. If the duplicate VIN was
entered in error, correct it; however, if the Form is submitted with a duplicate VIN, this will require
resolution before the Form is accepted by the EPA.
New Bus VIN © *
00000000000000000
0 characters remaining.
A Warning-Duplicate VIN Detected
A VIN has been detected thatmay have been used in this orother forms. It has been flagged for review.
New Bus Fuel Type ©
Electric
New Bus GVWR © *
35,000
lbs
New Bus Delivery Date © *
10/29/2025
New Bus Delivery Date is the actual
delivery date and differs from the
new bus delivery date listed within
the Bill of Lading (or other document)
New Bus Manufacturer © '
New Bus Model © *
Bus
New Bus EPA Vehicle Family ©
AAAAAAAAA/j
New Bus Model Year ©
2025
8. New Bus Fuel Type* is prepopulated from the information in the Funding Request Form and cannot be
changed after funds have been disbursed. If you change the New Bus Fuel Type when an existing bus
is swapped, you will not be eligible for a higher rebate than what you received in the Payment Request
form, but your Maximum Eligible Bus Rebate from Close Out Form may be reduced depending on
what fuel type you select. A reduction in Maximum Eligible Bus Rebate from Close Out Form may
require reimbursement of a portion of your rebate to the EPA.
9. New Bus GVWR* is prepopulated from the information in the Payment Request Form. The field is
editable if changes are needed from what was submitted in the Payment Request Form. Changing the
GVWR will not increase the Maximum Eligible Bus Rebate from Close Out Form but could decrease
it if the GVWR is lowered. The New Bus GVWR must match the GVWR on the Final invoice.
10. New Bus Delivery Date*: Enter the delivery date for the new bus in format MM/DDA'YYY or use the
calendar icon to select the date from the popup calendar.
a, Note: a date later than the date the Form is being completed cannot be entered. If the actual
date differs from the bus delivery date listed on the proof of delivery document, check the
box indicating that the date differs between actual date of delivery and proof of delivery If the
delivery date is past 05/29/2026, you should request an extension for submission of your Close
Out form by using the Change Request form accessed through the applicant dashboard.
£3
-------
11. Select the New Bus Manufacturer* from the drop-down menu. The available options for selection in
the menu depend on the New Bus FuelType selected. If the manufacturer of this bus does not appear,
then select "Other" and enter the manufacturer name in the New Bus Manufacturer (Other) field.
12. New Bus Model* is prepopulated from the information in the Payment Request Form; however, the
field is editable. Available selections are based on the New Bus Manufacturer selected. The New Bus
Model must match the New Bus Model on the Final Invoice; however, if the model is not available in
the menu selection, then selected "Other" and enter the model in the New Bus Model (Other) field.
13. New Bus EPA Vehicle Family needs to be populated with the 12-character alphanumeric EPA Vehicle
Family name or the 10-to-12-character CARB Executive Order ID.
a. To identify the EPA Vehicle Family, refer to the VECI label, which is usually on/near a door pillar or
on the engine compartment sheet metal and should be used to report the EPA Vehicle Engine
Family. Do not report any EPA Family Name information based on what is on an invoice.
i. Note: Vehicle Family information is also available at the EPA website but should only be
used if the VECI label is missing on the new bus: visit the Certification Data Spreadsheets
page, download "Heavy-Duty Vehicle Certification Data (Model Years: 2015- Present),"
and search the spreadsheet for your bus model. The first letter of the EPA Vehicle Family
represents the model year; see the EPA's /vebpaae on Vehicle Family naming for a list of
letters and model years.
b. If the bus is not an EPA-certified vehicle, enter the CARB Executive Order ID.
c. If the vehicle does not have EPA or CARB certification, contact the Clean School Bus helpdesk.
14. New Bus ModelYear* is prepopulated from the information in the Payment Request Form. If the new
bus has changed, the field is editable. The model year must be between 2022 and 2030.
15. Bus Shipping Costs*: This field will appear for buses serving school districts in Alaska, Hawaii, Puerto
Rico, U.S. Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana
Islands. If this field appears, enter the actual shipping costs for this bus based on the invoice document
associated with this bus.
16. ADA-Compliance Costs*: If the new bus is equipped with an ADA-compliant wheelchair lift, select
the checkbox, which is only available if you requested an ADA-Compliance rebate for this bus in the
Payment Request Form.
a. Then, enter the purchase price for equipping this bus with an ADA-compliant wheelchair lift. This
number should exactly match the line item for the wheelchair lift in the final invoice and should
not be included in New Bus Price field.
b. If you received a rebate for an ADA-Compliance wheelchair lift and did not install one on this bus,
you will need to submit a reimbursement in the amount of the rebate received for the ADA-
Compliance wheelchair lift. The EPA will provide information on how to reimburse the funds once
you submit your Close Out Form.
17. The Total Eligible ADA and Shipping Rebate field displays the eligible rebate for ADA-Compliance
and Shipping based on what was entered for this bus in the Close Out form. If this value is less than
the rebate you received for these costs based on the Payment Request Form, a reimbursement to the
EPA will be required.
-------
18. Reason for Change of Bus Information* will appear if changes have been made to the new bus
information provided in the Payment Request Form.
Please indicate in the field below why changes were made to this New Bus.
Reason For Change of Bus Information Q *
Reason For Charge of Bus Information is required
500 characters remaining.
19. New Bus Estimated Annual Mileage* requires you to enter the estimated annual miles the new bus
will travel.
20. At this point, different fields will appear for the new buses depending on the new bus fuel type.
21. For electric new buses only:
a. EV Battery Capacity* is only visible if the new bus fuel type is electric. Enter the rated battery
capacity of the bus in kilowatt hours (kWh).
b. The Estimated EV Bus Range* field requires you to enter the manufacturer's estimated range
in miles for the new electric vehicle (EV) bus. This field is only visible if the new bus fuel type is
electric. Estimated EV bus range may be identified in the Owner's Manual for the new bus.
c. Equipped with Auxiliary Heater?* prompts you to select Yes or No from the drop-down menu.
Select Yes if the new bus has an auxiliary heater.
d. Check the box for Heater installed in accordance with the Program Guide* if the auxiliary
heater is installed in accordance with the 2023 Clean School Bus Rebates Program Guide.
e. Use the Auxiliary Heater Externally Vented* field to indicate whether the heater is vented to
the outside of the bus.
f. Auxiliary Heater Fuel Type* is only visible if the bus is equipped with an auxiliary heater. Select
the auxiliary heater fuel type from the drop-down menu.
g. Auxiliary Heater Fuel Type (Other) is only visible if the auxiliary heater fuel type is "other."
h. Estimated Annual Idling Hours*: Enter the estimated annual idling hours for the new bus.
i. The Capable of Bidirectional Charging* field appears for electric buses and prompts you to
select Yes or No from the drop-down menu. Select Yes if the bus is capable of two-way charging
(e.g., grid-to-vehicle and vehicle-to-grid). Select 'no' if the bus can only receive energy and be
charged by the electrical grid (grid-to-vehicle).
j. For Battery Warranty Included, select Yes if the bus purchase includes a battery warranty.
-------
k. If the battery warranty covers a specific number of years, miles, or kWh of gross discharge
throughput, enter information in these fields.
I. Attach a file or scan of Battery Warranty Documents.
i. Allowed file types: *.pdf, *.png, *.jpeg, *.jpg
Minimum file size: 1 KB
Maximum file size: 5MB
m. Repeat steps i - k for the Powertrain Warranty.
22. For propane or CNG new buses only:
a. The New Bus estimated fuel consumption (gallons) field requires you to enter the estimated
annual fuel consumption for this new propane (gallons) or CNG (pounds) bus. This field is only
visible if the new bus fuel type is CNG or propane.
b. For Powertrain Warranty Included, select Yes if the bus purchase includes a powertrain
warranty.
i. If the powertrain warranty covers a specific number of years or miles, enter information in
these fields.
ii. Attach a file or scan of the powertrain warranty for the bus.
23. Photo of New Bus and VIN Documentation: Attach two photos for each new bus: a side view of the
entire bus and a photo of the VIN plate. Include the last four digits of the VIN number in the file name.
a. Allowed file types: *.pdf, *.png, *.jpeg, *.jpg
Minimum file size: 1 KB
Maximum file size: 5MB
b. Once you have completed the fields above, you must select the Complete button at the bottom
of the page before moving on. You must fill out all required information for every bus in your
fleet. Note: For the entered information to be "saved" you must either select the Next or Save
buttons at the bottom of the page.
-------
5.4 Complete Bus Information
Review the prepopulated fields in the "Bus CostTotals" section before moving on. If any of the Bus Cost
Totals are not accurate, review the information entered on the "Buses" page (page 6) and make edits where
necessary.
1. Number of Buses Requested is prepopulated from the information in your rebate application.
2. Number of Buses Ordered is prepopulated from the information in your Payment Request Form.
3. Number of Buses Received is the total number of new buses entered on this Close Out Form.
4. Total Bus Costs from Payment Request is the sum of all the bus costs from the Payment
Request Form.
5. Total Bus Costs (Actual) is the sum of the actual costs of all buses ordered based on information you
entered on this Close Out Form.
6. Total Bus Rebate Received is the sum of all the bus rebate values for each bus ordered and does not
include shipping of ADA-Compliance rebates.
7. Displayed if applicable: Total Shipping Rebate Received and Total ADA Rebate Received are the
total rebates received for all buses that received shipping and ADA rebates.
8. Displayed if applicable: Total Shipping Rebate Used (Actual) and Total ADA Rebate Used (Actual)
is the total eligible rebate based on the Close Out form for all buses that received shipping and ADA
rebates.
9. Displayed if Applicable: Total Shipping Costs (Actual) and Total ADA Costs (Actual) are the total
amounts you paid for shipping and ADA compliance for all buses.
10. Displayed if applicable: Total Shipping Cost Responsibility and Total ADA Cost Responsibility is the
total selectee responsibility for shipping and ADA costs that exceeds the eligible rebate based on this
Close Out form for all buses that received shipping or ADA rebates.
Once you have added all the bus information, select Next to continue.
Bus Cost Totals
Number of Buses Requested
(Application) Q
Total Bus Costs from Payment Request i
Total Bus Rebate Received Q
Number of Buses Ordered
(Payment Request) Q
Number of Buses Received (Close
Out) 0
O
o
o
Total Bus Costs (Actual) Q
S620.000.00
Total Shipping Rebate Received
S40,000.00
Total Shipping Rebate Used (Actual)
$30,000.00
©
I Total Shipping Costs (Actual)
$30,000.00
| ¦ Total Shipping Cost Responsibility
$0.00
Total ADA Rebate Received
$20,000.00
Total ADA Rebate Used (Actual)
$20,000.00
Total ADA Costs (Actual)
$20,000.00
Total ADA Cost Responsibility
$0.00
NOTE: Use of the browser back, forward, or refresh buttons will result in loss of work. Please navigate using the buttons at the bottom of the form.
-------
6. Infrastructure Information
On this page, you will edit or enter information about the infrastructure purchased with rebate funding.
Infrastructure items that were entered on your Payment Request Form will appear in the "Infrastructure
Information" section, as shown in the screenshot below. Select Edit to check accuracy of entered data and
complete any blank fields. All information entered should exactly match the infrastructure information included
on the final infrastructure invoice. Select + Add Infrastructure to add information for additional electric vehicle
supply equipment (EVSE) or other eligible infrastructure costs (e.g., installation costs).
of
11 Infrastructure
Since yau took delivery of an electric school bus(es|, enter information about installed infrastructure and other infrastructure costs for this project (see Build America, Buy America Act (BABA!
Implementation Procedures for EPA Office of Transportation and Air Quality Federal Financial Assistance Programs for items that should be part of project! that are eligible for a rebate on this
page even ifyou don't plan to use rebate funds to cover costs of this infrastructure. On the Funding page you will be able to allocate eligible rebate funds you received to buses and/or
infrastructure you listed on this page.
Note: The term EVSE on this page means "electric vehicle supply equipment |charger|".
You will need the following information to complete the fields on this screen:
EVSE information (type, manufacturer, model, maximum output power, date of manufacture, number of plugs, bidirectional charging capability, and Energy Star compliance if Level 2
charger)
All costs associated with EVSE installation
Other eligible infrastructure costs (type, description of work)
Infrastructure installer and owner (applicant, school district or entered on Organizations page]
Proof of delivery documents for each instal led EVSE (selected from information entered on Documents page]
Final invoice documents for each installed EVSE and other eligible infrastructure costs ^selected from information entered on Documents page)
Infrastructure supplier organization (populated from entered information on Organizations page and selections made on Documents page)
Address where EVSE or other eligible infrastructure was installed
Photo of each installed EVSE
Photo of charging equipment serial number
' denotes required field
Infrastructure Information
Enter information for each type of EVSE that was purchased. Enter the cost of installation and any necessary electrical/construction work separately. If you don't have a breakdown of
installation and EVSE cost, enter the full amount in the EVSE cost field.
Infra. Number
i
Infra. Type: level 2Charger
Manufacturer: ChargePoint
Model: 1234
Quantity: 2
Cost (per item): $1,234
Subtotal: $2,468.00
Infrastructure Information Incomplete
Click the "Edit" button for this row, and complete all required fields.
+ Add Infrastructure
Return to Organization Entry
Return to Document Entry
-------
6.1 Add Infrastructure—Level 2/Direct Current (DC) Fast Chargers
In this section, you wiii enter information for each type of EVSE that was purchased with rebate funding. Enter
the cost of installation and any necessary electrical/construction work as a separate item. If you do not have a
breakdown of installation and EVSE cost, enter the full amount in Infrastructure Cost per Charger.
Note that each infrastructure line item cost must match exactly the amount on the infrastructure
invoice. You must either: a) include each line item in the Close Out Form as it appears on invoice, or b) split the
cost of a line item that served multiple chargers such that the whole cost is included across the line items on
your Close Out Form (i.e., divide the invoice line item by the number of chargers and include the result in each
charger line item on the Close Out Form).
Once you select + Add Infrastructure, select the infrastructure type from the drop-down menu. For Level 2
chargers and DC fast chargers, you will see the following fields:
Infrastructure Information
Infrastructure Type & *
Infrastructure#
1
Level 2 Charger
EVSE Maximum Output Power (kW) © "
Infrastructure Quantity O *
EVSE Manufacturer i
Infrastructure Cost per Charger Q *
$1,234.00
Total Taxes and Other Fees '
SO.OQ
Infrastructure Subtotal €}
S2.46S.00
Total Cost Listed an Invoice 6 '
52,468.00
3 Cost Includes Installation 0
i ^ EVSE Capable of Bidirectional Charging? O
J This Charger Is Energy Star Compliant 0 *
J This Charger or Infrastructure Materials Is Buy America
Compliant Q
Infrastructure Installer Q
This field is mandatory to complete the Close Out Form but is not required to complete and save the infrastructure information.
Infrastructure Owner 0
Org Name: 1 Contact Name:
This field is mandatory to complete the Close Out Form but is not required to complete and save the infrastructure information.
Electrification as a Service (EaaS provider) 0
This field is mandatary ta complete the Close Out Form but is not required to complete and save the infrastructure information.
EVSE Model 0 '
1234
EVSE Date of Manufacture *
10/31/2025
EVSE Date of Installation *
11/10/2025
Number of Plugs on EVSE O '
-------
The data fields associated with Level 2 and DC fast chargers are described below, with required fields marked
with an asterisk.
1. The Infrastructure Type* field requires you to select a charging infrastructure type from the drop-down
menu. You must specify all infrastructure items purchased with rebate funds. The options are Level 2
Charger, DC Fast Charger, or Other Eligible Infrastructure Costs.
2. EVSE Maximum Output Power (kW)* requires you to enter the rated maximum output power of the
charger (in kilowatts). The kilowatts (kW) for a Level 2 Charger should not be higher than 20 kW and for
a DC Fast Charger the kilowatts should not be less than 20 kW.
3. Infrastructure Quantity* needs to be populated with the number of chargers purchased of that
charger type that had the same cost per charger. If multiple types of chargers were purchased, or
chargers of the same type have different costs, each must be entered separately.
4. Enter the unit cost for each charger (plus installations costs if cannot be reported separately) in the
Infrastructure Cost per Charger field. Enter the unit cost for each charger (plus installations costs if
not reported separately). Cost should not include taxes and other fees. Enter any taxes and other fees
in theTotalTaxes and Other Fees field.
5. Select the EVSE Manufacturer* from the drop-down menu. If the manufacturer is not listed, select
Other and enter the manufacturer in the EVSE Manufacturer (Other) field below.
6. Enter the price per charger in the Infrastructure Cost Per Charger* field. This price should exactly
match the cost per charger on the final infrastructure invoice.
7. The EVSE Model* is the model of the infrastructure hardware purchased.
8. Enter the TotalTaxes and Other Fees* in this field if they are listed separately on the invoice.
9. Select the EVSE Date of Manufacture* from the drop-down calendar, or by entering the date in the
following month, day, year format, MM/DD/YYYY.
10. The Infrastructure Subtotal field is read only and displays the subtotal for each infrastructure
line item.
11. Select the EVSE Date of Installation* from the calendar or by entering the date in the following
month, day, year format: MM/DD/YYYY
12. Enter the Total Cost Listed on Invoice* that is the sum of all equipment costs, fees, and taxes
associated with this infrastructure item. If the value in this field does not match the value in the
Infrastructure Subtotal field, a warning message will appear asking you to resolve the difference. If the
difference in values cannot be resolved, it will require additional EPA review but will not prevent you
from submitting the Close Out form.
13. The Cost Includes Installation box should be selected if the infrastructure cost per charger includes
installation.
14. Enter the number of plugs per charger in the Number of Plugs on EVSE* field.
15. EVSE Capable of Bidirectional Charging? Check this box if the charger is capable of vehicle-to-grid
charging (i.e., the EVSE can both receive energy and provide energy).
16. Planning to Use Bidirectional Charging? checkbox appears if your EVSE is capable of bidirectional
charging, and you plan to use vehicle-to-grid charging.
-------
17. This Charger is Energy Star Compliant: Check this box to certify that the infrastructure is Energy
Star certified for Level 2 chargers. All Level 2 chargers must be Energy Star Compliant.
18. This Charger or Infrastructure Material Is Build America, Buy America Compliant: Check this box
to certify that this infrastructure meets the Build America, Buy America program requirements outlined
in the 2023 Clean School Bus Rebates Program Guide.
19. Select the Infrastructure Installer from the drop-down menu. If you do not see the organization in
the menu, return to the "Organizations" page (see Return to Organization Entry button), enter the
organization and then return to this field to select the organization from the menu.
20. Select the Infrastructure Owner from the drop-down menu. If the name does not appear on the list,
select the Return to Organization Entry button to enter the owner's information.
21. Select the Electrification as a Service (EaaS provider) (if applicable) from the drop-down menu. If the
name does not appear on the list, select the Return to Organization Entry button to enter the EaaS
provider's information.
Note: If a single invoice lists multiple infrastructure items, the total tax needs to be apportioned for each piece
of equipment or installation charge.
Next, add the address where the EVSE was installed.
In the "Documents and Photos" section, add the final invoice and proof of delivery documents using the
drop-down menus. If you do not see the documents required, select Return to Document Entry to add them.
Note: The Infrastructure Vendor field is auto filled when you select the Final Invoice document above.
Finally, upload an image of the charging equipment after installation.
Allowed file types: *.pdf, *.png, *.jpeg, *.jpg
Minimum file size: 1 KB
Maximum file size: 5MB
Once the required information is entered, select Complete.
-------
6.2 Add Infrastructure—Other Eligible Infrastructure Costs
To enter information on non-EVSE infrastructure costs such as construction materials, design, permitting, and
labor, select Other Eligible Infrastructure Costs from the Infrastructure Type drop-down menu. Only include
infrastructure items that were purchased with Clean School Bus rebate funding. The data fields associated
with these costs are shown below, with required fields marked with an asterisk.
Infrastructure Information
Enter information for each type of EVSE that was purchased. Enter the cost of installation and any necessary electrical/construction work separately. If you don't have a breakdown of
installation and EVSE cost, enter the full amount in the EVSE cost field.
I Infrastructure#
Infrastructure Information
1
Infrastructure Type 0 *
Other Eligible Infrastructure Costs
nfrastructure Type (Other) £ *
Other Eligible Infrastructure Cost 0 *
Infrastructure Materials Only (e.g. wiring, panels, conduit) Z
S30.000.00
Description of Work G "
Total Taxes and Other Fees "
infrastructure material cost
so.oo
nfrastructure Subtotal 0
530,000.00
A
Total Cost Listed on Invoice Q *
ATI characters remaining.
530,000.00
3 This Charger or Infrastructure Materials Is Buy America
Compliant ©
Infrastructure Installer Q
Org Name: Infrastructure Dealer ] Contact Name:
This field is mandatory to complete the Close Out Form but is not required to complete and save the infrastructure information.
Infrastructure Owner 0
Org Name: Infrastructure Dealer | Contact Name:
This field is mandatory to complete the Close Out Form but is not required to complete and saw the infrastructure information.
Electrification as a Service I EaaS provider) 0
Org Name: Not Applicable | Contact Name:
This field is mandatory to complete the Close Out Form but is not required to complete and save the infrastructure information.
1. The Infrastructure Type* field requires you to select a charging infrastructure type from the drop-down
menu. In this case, select Other Eligible Infrastructure Costs.
2. Select the Infrastructure Type (Other)* from one of the following categories: Infrastructure Materials
Only; Infrastructure Materials, Design, Labor and Permitting etc.; Infrastructure Design, Labor and
Permitting etc. Only (no materials). If your other infrastructure costs fit into more than one of the
categories, you'll need to enter multiple line items.
3. For the Description of Work*, provide a detailed description of the infrastructure-related work entered
in the Other Eligible Infrastructure Cost field.
-------
4. Other Eligible Infrastructure Cost* must be populated with the total of all other eligible infrastructure
costs, including materials, design, labor, and permitting for this line item. Do not include taxes and
other fees in the value entered as this will be entered in the field below.
5. Enter the TotalTaxes and Other Fees* if they are delineated separately in the invoice (if applicable).
6. The Infrastructure Subtotal field is read only and displays the subtotal for each infrastructure
line item.
7. Total Cost Listed on Invoice* is the sum of other eligible infrastructure costs, taxes, and fees. A
warning will appear if the entered cost does not match the total listed in the Infrastructure Subtotal
field. The Form will ask you to fix discrepancies; however, if differences cannot be resolved, you can
continue the Form, but the information will require additional review.
Next, select the Infrastructure Installer, Infrastructure Owner, and if applicable. Electrification as a Service
(EaaS Provider) from the drop-down menus in these fields. If you do not see the organizations needed, select
Return to Organization Entry to add them.
Then add the address where the other eligible infrastructure is installed. The address will be prepopulated with
the previous address entered for other infrastructure line items but can be edited if needed.
Finally, add a final invoice for the associated cost using the drop-down menu. If you do not see the document
required, select Return to Document Entry to add it. Note: The Infrastructure Vendor field is auto filled when
you select the Final Invoice document above.
Once the required information is entered, select Complete.
You can add another infrastructure item by selecting + Add Infrastructure at the bottom of the Infrastructure
Information section on the page. You may add as many infrastructure items as needed and delete or edit them
at any time.
The "InfrastructureTotals" section at the bottom of the page shows the infrastructure totals from the
Payment Request Form and the Close Out Form (listed as "Actual" at the end of the field name) broken out by
infrastructure type. Select Next to proceed to the "Funding" page.
Infrastructure Totals
Level 2 Charger Costs from Payment Request $2,468.00
DC Fast Charger Costs from Payment Request $0.00
Other Infrastructure Costs from Payment Request $0.00
Total Infrastructure Costs from Payment Request Q $2,468.00
Total Infrastructure Rebate Received Q $2,468.00
Level 2 Charger Costs (Actual) Q $2,468.00
DC Fast Charger Costs (Actual) Q $0.00
Other Infrastructure Costs (Actual) Q $0.00
Total Infrastructure Costs (Actual) Q $2,468.00
£J
-------
7. Funding Information
On this page, you will allocate your awarded CSB rebate funds to each bus and to infrastructure based on the
total eligible rebate for bus and infrastructure identified on the "Buses" page. The eligible ADA and shipping
rebates were determined on the "Buses" page and are not part of the allocations on this page; however, they
are shown in the bus funding allocation section for information only.
7.1 Bus Funding Allocations
Select Edit for each listed bus to allocate funding to each bus. The screenshot below shows the Edit button
for Bus 1 and the fields that appear once the Edit button is selected for Bus 2.
Bus Funding Allocations
Bus
1
Existing Bus VIN 11111111111111111
Existing Bus Fuel Type: Diesel
New Bus Fuel Type: Electric
New Bus Rebate Amount: 5345,0(10
New Bus Purchase Price: S320,000
Funding Allocation: $320,000
Bus # Q
2
Existing Bus VIN O
1234567S9Q12345S7
Existing Bus Fuel Type G
Diesel
New Bus Fuel Type O
Electric
Shipping Rebate Used
$10,000.00
ADA Rebate Used
$10,000.00
New Bus Purchase Price Q
$300,000.00
Eligible Bus and Infrastructure Rebate
Amount ©
$345,000.00
Bus Rebate Amount Received Q
$300,000.00
Funding Allocation for This Bus 0
$300,000.00
Remaining Rebate Amount for This Bus
e
$0.00
Remaining Rebate Amount for
Infrastructure ©
$45,000.00
Complete
Total Bus Rebate Received from Payment Request
$620,000.00
Total Eligible Bus Rebate Amou nt in Close Out ©
$620,000.00
Total Bus Costs
$620,000.00
Rebate Amount Allocated to All Buses
$620,000.00
Total Remaining Rebate Amount far All Buses
$0.00
For the Funding Allocation for This Bus*, enter the amount of rebate funding that you want to allocate to this
bus. The amount entered cannot be more than the New Bus Purchase Price or the Bus Rebate Amount
Received, whichever is less. For electric buses, any remaining unallocated rebate funding for this bus will be
available for eligible infrastructure costs.
-------
The amounts at the bottom of this box show the following:
¦ The Total Bus Rebate Received from Payment Request, which is the amount of rebate funding
received based on the Payment Request form.
¦ The Total Eligible Bus Rebate Amount in Close Out, which is the maximum that can be allocated
to all buses and is either the sum of the "New Bus Purchase Price" for each bus included in the Close
Out Form, orthe amount listed in the "Total Rebate Amount Received" which ever field is a lower
amount.
¦ The Rebate Amount Allocated to All Buses, which is the sum of all the allocations for each bus
included in the Close Out Form.
¦ The Total Remaining Rebate Amount for All Buses, which is the funding (if any) available to allocate
to remaining buses listed in the Close Out Form (i.e., buses for which you have not yet entered funding
allocations) or any infrastructure associated with those buses.
The Total Bus Reimbursement Owed to EPA from Bus Exclusions and Rebate Reductions field will appear
at the bottom of the Bus Funding Allocations section due to the following changes on the "Buses" page:
¦ Bus(es) were excluded on the "Buses" page and a reimbursement of the amount of rebate paid for
that bus(es) is/are needed.
¦ A reduction in the GVWR that reduces the maximum eligible bus(es) rebate for a bus to below the
rebate received for bus(es).The difference between the maximum rebate amount for the bus with the
new GVWR and the rebate paid for the bus(es) must be reimbursed to the EPA.
ToLal &us Costs
$764,000.00
0 Warning - Rebate Amount Refund Required
The bus exclusions provided on this Form indicate thai you are eligible for less rebaLe Funding than the rebate amount you were paid based on the approved
Payment Request Form. Additiona l acuons will be necessary alter submittal and review of the Close Out Form to settle this balance.
ToLal Bus Rebate Received from Payment Request
$920,000.00
Rebate Amount Allocated to All Buses
Total Eligible Bus Rebate Amount in Close Out 6
$610,000.00
Total Remaining Rebate Amount Tor A] I Buses
$0.00
Total Bus Reimbursement Owed lo EPA from Bus
Exclusions artd Rebate Reductions 0
S345.000.00
Total Bus Reimbursement Owed io EPA from Bus
funding Allocations
£
-------
Any non-EPA funding that was received for buses must be entered in the next section. This includes any
funding provided by the applicant organization or school district. Select + Add Funding, then enter each non-
EPA funding source separately. Select the type of funding source1, enter the name of the funding source, and
enter the total amount from that funding source. When finished, select Complete.
Non-EPA Clean School Bus Funding information
Enter all sources of non-EPA funding that were used to purchase new bus{es).
Note: The total of eligible funding for bus rebates from this form and other eligible external funds used to meet the total bus cost responsibility should not exceed the cost of the new
buses.
Non-EPA Funding Type 0 * Non-EPA Funding Source O * Non-EPA Funding Amount Q *
+ Add Funding
Total Non-Program Funding Acquired Q
SO.OO
Non-EPA Bus Funding Not Accounted For Q
$0.00
When all non-EPA funding sources and amounts are added, check that the Non-EPA Bus Funding Not
Accounted For amount is $0.00. If it is not, a warning message will appear. If the amount is a negative value,
the warning will state that the funding amount exceeds the bus and infrastructure costs, and you may owe
reimbursement to the EPA. If the value is a positive amount, the warning will state that you have insufficient
funds to cover the costs of your buses.
7.2 Infrastructure Award Allocations
In the "Infrastructure Award Allocations" section, enter the rebate amount you would like to allocate to
infrastructure in the Funding Allocation for All Eligible Infrastructure Costs field. You cannot allocate more
than either the Unallocated Bus Rebate Eligible for Infrastructure OR Total Eligible Infrastructure Costs
fields, whichever value is less. Any unallocated funds will reduce the amount of your rebate and will result in a
reimbursement owed to EPA for the unallocated funds.
Infrastructure Award Allocations
Infra. Infra. Type: Level 2 Charger Quantity: 2
Manufacturer: Cost (per item): $1,234
Model: 1234 Subtotal: $2,468.00
Unallocated Bus Rebate Eligible for Infrastructure Q
$245,000.00
Total Eligible Infrastructure Costs Q
$2,468.00
Funding Allocation for All Eligible Infrastructure Costs Q '
$2,468.00
1 The proposed replacement bus and any associated charging infrastructure to be paid for in part by CSB funds must
not also be funded by other federal funds. Fleets can use external non-federal funding sources as part of their bus
replacement project but must confirm with the source of those funds that they are not pass-through federal funds.
Volkswagen Environmental Mitigation Trust Funds may be used as external funds provided that the WV trust funds are
associated with Eligible Mitigation Action (EMA) #2. VW trust funds under EMA #10, the DERA Option, are not eligible
external funds.
-------
Next, add ail sources of non-EPA funding that were used to purchase or construct infrastructure to support
electric buses. This includes any funding provided by the applicant organization or school district. Check that
the Non-EPA Infrastructure Funding Not Accounted For amount is $0.00. If it is not, a warning message
will appear. If the Non-EPA Infrastructure Funding Not Accounted For amount is a negative value, the
warning will state that the funding amount exceeds the bus and infrastructure costs, and you may owe a
reimbursement to the EPA. If the value is a positive amount, the warning will state that you have insufficient
funds to cover the costs of your infrastructure (if purchasing electric buses). You may continue submitting the
Close Out Form despite the warning that you have insufficient funds to cover the costs of your buses, but you
are encouraged to include any non-EPA funding to cover eligible project costs.
Non-EPA Clean School Bus Infrastructure Funding Information
Enter all sources of non-EPA funding that were used to purchase and/or construct infrastructure to support electric buses.
Note: The total of eligible funding for infrastructure rebates from this form and other eligible external funds used to meet the applicant infrastructure cost responsibility should not
exceed the total cost of the charging infrastructure.
Non-EPA Funding Type Q ' Source of Additional Non-EPA Funding Q * Non-EPA Funding Amount Q '
Complete
+ Add Funding
Total Infrastructure Non-EPA Funding Acquired Q
$0.00
Non-EPA Infrastructure Funding Not Accounted For Q
$0.00
Interest Earned on CSB Rebate: all interest earned on CSB Rebate funding must be returned to the EPA.
CSB Rebate selectees will need to confirm whether CSB Rebate funding did or did not earn interest. If
interest was earned, instructions on how to return earned interest will be sent during the review process.
Interest was Earned on Rebate Funds Received Q '
The amount of any reimbursement for infrastructure costs will be displayed in the Infrastructure
Reimbursement Owed to EPA field. The reimbursement due is the sum of any unallocated bus rebate that is
eligible for infrastructure and any excessive non-EPA funding for infrastructure.
Q Warning - Rebate Amount Refund Required
The infrastructure cost totals provided are either less than the infrastructure awarded amounts, and/or the non-EPA funding plus infrastructure rebate exceeded the
infrastructure project costs. Additional actions will be necessary after submitting the Close Out Form to settle this balance.
Infrastructure Reimbursement Owed to EPA from Bus ^ ^
Exclusions and Rebate Reductions Q
Infrastructure Reimbursement Owed to EPA O $242,532.00
The following fields will appear at the bottom of the "Funding" page if a reimbursement is due to the EPA.
-------
The Total Bus ADA and Shipping Reimbursement Owed is the reimbursement needed for ADA and
shipping calculated on the "Buses" page.
The Total Bus and Infrastructure Rebate Owed to EPA is the total reimbursement owed to the EPA and
includes the sum of all reimbursements calculated on the Bus and Funding pages (see screenshot below).
Total Reimbursement Owed to EPA is the sum of the Total Bus ADA and Shipping Reimbursement Owed
and the Total Bus and Infrastructure Reimbursement Owed to EPA.
Select Next to move forward.
0 Warning - Rebate Amount Refund Required
The actual eligible rebate totals calculated from costs you provided on this form are less than the sum of the paid rebate amount and any additional Non-EPA funding you
received. Additional actions will be necessary after submittal and review of the Close Out Form to settle this balance.
Total Bus ADA and Shipping Reimbursement Owed Q $15,000.00
Total Bus and Infrastructure Rebate Owed to EPA Q $242,532.00
Total Reimbursement Owed to EPA O $257,532.00
-------
8. Build America, Buy America Compliance
On this page you will confirm whether the infrastructure for this rebate project is Build America, Buy America
Act (BABA) compliant with additional attestation. All infrastructure for this project - including materials
identified on the "Infrastructure" page as well as other infrastructure that the EPA is not funding - must meet
BABA requirements.
The EPA interprets a "project" covered by BABA as consisting of any activity relating to the construction,
alteration, maintenance, repair of infrastructure and associated activities necessary to complete the work
regardless of the number of contracts or assistance agreements involved so long as all the contracts and
assistance agreements awarded are closely related in purpose, time, and place (PTP test).
See FAQ Q2.3 and Q2.4 in OTAQ's BABA Implementation Procedures document for more information on the
definition of "project" and using the "Purpose,Time, and Place" test to determine project scope. See also
Q2.12 and Q2.13 for more discussion of the applicability of BABA to fueling infrastructure purchased with non-
federal funding.
For additional information on BABA to inform you of your responses to the questions, please refer to
documents linked below:
Revised FAQ 3.34 in , for
infrastructure purchasing that was initiated before August 8, 2025.
¦ OTAQ's BABA Implementation Procedures document
¦ General Applicability Waivers
¦ For additional questions on BABA contact cleanschoolbus@epa.aov or BABA-QTAQ@epa.aov.
As described in detail on the signature page of this Close Out Form, your responses below are a material
representation to the EPA as complete and accurate information. The EPA, the Agency's authorized
representatives, and/or the Office of Inspector General will conduct random reviews of selectees to verify
information provided below and protect against waste, fraud, and abuse.
Select the appropriate option from the Is Infrastructure used in this project BABA compliant? drop-down
menu. The menu options are the following:
¦ Yes, all project infrastructure meets BABA requirements, including non-EPA funded infrastructure for
which the purchasing process was initiated after August 8, 2025.
¦ Yes, I am using a BABA waiver for some or all project infrastructure
If you used a waiver, you must select which type(s) of waiver(s) you used from the list of approved
general applicability BABA waivers and/or select "Approved Project-Specific Waiver." Choosing an
Approved Project-Specific Wavier will open two additional fields that must be completed, Project-
Specific Waiver Name, and Date Approved. The \pproved Waivers link takes you to an EPA webpage
that lists all the BABA waivers approved by the EPA.
¦ No, BABA does not apply to this project
Selecting this option requires you to attest to one of two options to the following field "Based on the
guidance you reviewed above regarding the definition of project and the Purpose,Time, and
Place (PTP) test, attest to one of the following." The options are the following:
-------
— The purchasing process for the charging or other fueling infrastructure was initiated prior to
August 8, 2025, and was not funded through the CSB rebate.
— Fueling infrastructure for the EPA-funded buses is not part of the same project as the EPA-
funded buses based on the PTP test
Select Next when you are finished entering the BABA information.
of 11 Build America, Buy America Compliance
On this page, you will confirm whether the infrastructure for this rebate project is Build America Buy America Act (BABA) compliant with additional attestation. All infrastructure for this
project - including materials identified on the "Infrastructure" page as well as other infrastructure that EPA is not funding - must meet BABA requirements.
The EPA interprets a "project" covered by BABA as consisting of any activity relating to the construction, alteration, maintenance, repair of infrastructure and associated activities necessary to
complete the work regardless of the number of contracts or assistance agreements involved so long as all the contracts and assistance agreements awarded are closely related in purpose,
time, and place {PTP test).
Note when infrastructure is part of the same project funded by CSB, BABA applies to the infrastructure even if federal funding is not used for the infrastructure. See FAQ 02.3 and 02.4 in
QTAOs BABA Implementation Procedures document for more information on the definition of "project" and using the "Purpose, Time, and Place" (PTP) test to determine project scope. See
also Q2.12 and Q2.13 for more discussion of the applicability of BABA to fueling infrastructure purchased with non-federal funding.
For additional information on BABA to inform your responses to the questions, please refer to documents listed below:
• Revised FAQ 3.34 in 2023 CSB Rebate Program supplemental questions and answers, for infrastructure purchasing that was initiated before August 8,2025.
• OTAO's BABA Implementation Procedures document.
• General Applicability Waivers.
• For additional questions on BABA contact cleanschoolbus@epa.gov. or BABA-OTAO@epa.gov.
As described in detail on the signature page of this Close Out Form, your responses below are a material representation to the EPA as complete and accurate information. The EPA, the
Agency's authorized representatives, and/or the Office of Inspector General will conduct random reviews of selectees to verify information provided below and protect against waste, fraud,
and abuse.
* denotes required field
BABA Compliance
Is the infrastructure used in this project BABA-compliant? © *
No, BABA does not apply to this project
Based on the guidance you reviewed above regarding the definition of project and the PTP test, attest to one of the following: *
@ The purchasing process for the charging or other fueling infrastructure was initiated prior to August 8,2025 and was not funded through the CSB rebate
Fueling infrastructure for the EPA-funded buses is not part of the same project as the EPA-funded buses based on the Purpose, Time, and Place test
-------
9. Telematics
©of 11 Telematics
This page highlights the value of telematics, asks whether you are interested in EPA contacting you about research opportunities to provide telematics data, and if so, who the contact is for
telematics information.
Most of today's school buses are equipped with sophisticated fleet management systems, known as "telematics", to improve the safety and efficiency of the bus fleet. Telematics systems may
provide data on bus speed, location, and engine status to allow real-time tracking of routes, monitor compliance with safety requirements, and pinpoint maintenance issues as they arise.
These data can also serve as an important resource for districts looking to improve efficiency and reduce emissions. As electric vehicles enter the school bus fleet, telematics can contribute to
their successful implementation by providing data on bus range, battery performance, charging efficiency and other metrics for a variety of locations and operating conditions.
Participating in EPA research opportunities by providing telematics data could: help improve the national roll-out of electric school buses, allow operators to benchmark their fleet
performance, and identify additional opportunities to improve efficiency and lower costs.
Note, all telematics data received will comply with applicable Federal privacy requirements.
Telematics Data
~ PA or its partners may contact me about participating in research opportunities to provide bus or EVSE telematics data that could inform future transportation work.
If you are willing to share your telematics-related information with the EPA, select the check box. Next,
select the appropriate contact. If you would like to provide separate contact information from your primary or
alternate contact and that contact is not available in the drop-down menu, return to the "Organizations" page
to enter a telematics contact, and then return to this page to select the Telematics Contact.
Select Next to proceed.
-------
10. Signature
Review the summary cost, rebate received, and rebate used information provided at the top of the page
before you sign the Close Out Form.
©of 11 Signature
* denotes required field
Summary
Total Bus Costs (Actual)
$411,111.00
Total Infrastructure Costs (Actual)
$2,468.00
Total Combined Costs Q
$413,579.00
Total Applicant Responsibility Q
$0
Rebate Received
Total Bus Rebate Received
$141,111.00
Total Infrastructure Rebate Received
$2,468.00
Rebate Used
Total Bus Rebate Used (Actual)
$130,000.00
Total Infrastructure Rebate Used (Actual)
$2,468.00
Total Combined Rebate Received
$143,579.00
Total Combined Rebate Used (Actual)
$132,468.00
The Name and Title fields on this page are prepopulated for the authorized representative name from
the person who initiated the Form using SAM.gov point of contact information. If you are the authorized
representative, confirm your title in the 'Title' field, update if needed. If you do not have the authority to sign
this form, then notify the authorized representative so they can sign and submit the Form. They must also be
a SAM.gov point of contact for your organization and will need to use Login.gov to enter the Clean School Bus
Rebate Forms site to complete the Close Out Form (saved as a draft). In this case, they must edit the Name
and Title fields on this page to show their full name and title before signing and submitting.
If you sign and confirm signature but then return to a previous page to make edits, you will need to repeat the
signature and confirmation steps to submit your form.
To complete your Close Out Form, you must read and agree to the numbered list under "Signature and
Certification," sign, confirm signature, and select Submit Form.
-------
Name Q *
Name is required
Title O *
MANAGER
Electronic Signature of Authorized Representative *
*
~ I confirm I have provided my signature above *
NOTE: Use of the browser back, forward, or refresh buttons will result in loss of work. Please navigate using the buttons at the bottom of the form.
10.1 Missing Document or Organization Information
If any information is missing, a warning will pop up on the "Signature" page indicating what is missing.
Select Back to Bus Information Entry if you have any bus information missing and Back to Infrastructure
Information Entry if you have any missing infrastructure information. Once you submit all missing
information, go back and sign and submit the Close Out Form.
Q Warning - Missing Document and/or Organization Information
There is missing Document and/or Organization information in this Close Out Form. Please see the list below. Providing information in these fields is mandatory before
your Close Out Form can be submitted.
~ All Bus Information Complete *
Bus Information
The following fields are missing. Please complete before submitting the Close Out Form.
• ScraP Yar"d Organization, Transportation Service Provider (TSP), New Bus Final Invoice
• Existing Bus Owner, Scrap Yard Organization, Transportation Service Provider (TSP), New Bus Final Invoice
Back to Bus Information Entry
| j All Infrastructure Information Complete *
Infrastructure Information
The following fields are missing. Please complete before submitting the Close Out Form.
• Il Electrification as a Service (EaaS provider), Final Invoice, Proof of Delivery
Back to Infrastructure Information Entry
-------
11. Next Steps
The EPA will conduct a thorough review of your Close Out Form submission for completeness and accuracy.
We will follow up with questions as needed. After Close Out Form submission, please monitor your email
for any requests for edits from the EPA, with the expectation to respond to these requests within three
business days. Submission of the Close Out Form does not constitute the end of project compliance, as you
will need to ensure that all requests for edits are addressed, and documentation is retained in the event of a
site visit. Please refer to the Terms and Conditions in the 2023 CSB Program Guide for details on requirements
throughout the duration of your CSB project.
-------
Appendix A: Glossary
This appendix defines terms and abbreviations used throughout the Close Out Form and system pages.
"Your Rebate Forms" Page
¦ Rebate ID: Unique six-digit ID assigned by the EPA to each rebate request.
¦ Form Type: Application, Payment Request, or Close Out.
¦ Form Status: Draft, submitted, or funding approved.
¦ UEI: Unique entity ID from SAM.gov.
¦ EFT Indicator: Electronic funds transfer indicator for the associated bank account from SAM.gov.
¦ Applicant: Legal business name from SAM.gov for this UEI.
¦ School District: School district served by the new buses for the next five years.
¦ Updated By: Last person to update the Form.
¦ Date Updated: Last date this form was updated.
¦ Change Request: The Change Request Form allows you to edit, extend, or withdraw a form
depending on its status.
"Applicant Info" Page
Total Rebate Funds Requested in Application: This field is prepopulated with the funding amount
you requested in your Application Form.
Total Rebate Funds Received from Payment Request:This field is prepopulated with the funding
amount you received according to your Payment Request Form.
Applicant Organization Name: Your applicant organization's SAM.gov name is prepopulated, based on
the organization you entered on your Application Form.
Unique Entity Identifier (UEI):This is your applicant organization's SAM.gov UEI, prepopulated based
on the organization you chose when starting your application.
Electronic FundsTransfer (EFT) Indicator:This is your SAM.gov EFT indicator, prepopulated based on
the organization you chose when starting your application.
Physical Street Address, City, State, Zip Code: These address fields are prepopulated from your
SAM.gov registration and Application Form.
Organization County: The county where the applicant organization is located is an editable field.
¦ Applicant Primary Contact: Review the primary contact information for the applicant. The primary
contact may or may not be someone different from the applicant organization SAM.gov point of
contact. Edit the primary contact information if there are any errors.
¦ Update Primary Contact: Checking this box will allow you to update any primary contact fields.
¦ Replace Primary Contact: Checking this box will delete all the existing primary contact entries,
allowing you to add a new primary contact.
-------
¦ Applicant Alternate Contact: If applicable, review the alternate contact for the applicant. The alternate
contact may or may not be someone different from the applicant organization POC. Edit the alternate
contact information if there are any errors.
Clear Alternate Contact Information: This button can be used to delete all alternate contact fields.
School District Info" Page
National Center for Education Statistics (NCES) District ID:The NCES District ID was imported
into this form from your application and is not editable. This is the school district that the new buses
will serve for the next five years. If you do not have an NCES District ID, contact the help desk at
cleanschoolbus@epa.aov.
School District Name and Address: The name and physical address of the school district that the new
buses will serve.
¦ Prioritized: Read-only field, filled with Yes or No based on whether the school district meets
prioritization criteria.
¦ Priority Reason: The reason(s) for which your school meets the prioritization criteria.
Are you self-certifying as prioritized?: If self-certification is applicable, this field will display the self-
certification category from the Payment Request Form.
School District Contact Information: Review the school district contact person's information. The
school district contact may be someone different from the primary (or alternate) applicant contact. Edit
the school district contact information if there are any errors.
¦ Update School District Contact: Checking this box will allow you to update any school district
contact fields.
Replace School District Contact: Checking this box will delete the existing district contact entries,
allowing you to add a new school district contact.
Organizations" Page
¦ Organization Type: Check the boxes for all types that apply to your organization:
— Scrap Yard (existing bus): Any organization that scrapped an existing bus.
— Donee (existing bus): Any organization that received a donated existing bus from the applicant.
— Purchaser (existing bus): Any organization that purchased an existing bus from the applicant.
— Existing Bus Owner: All existing bus owners that are not the applicant, or the public school
district or public charter school that the new buses will serve.
— New Bus Owner: All new bus owners (e.g., school district, nonprofit, private fleet. Tribe) that are
not the applicant, or the public school district or public charter school that the new buses
will serve.
— Private Fleet (existing or new buses): Any private fleet that is not owned by the applicant.
A school district that contracts out bus service to multiple private fleets may only submit one
application but may list multiple private fleets on the application.
— New Bus Dealer: The vendor or dealer that the new bus owner will purchase the bus from.
— New Bus Service Provider: Any organization that is paid by the selectee or school district to
provide fleet services including bus operation, management or total bus management and is not
otherwise listed in the Close Out Form.
-------
— Infrastructure Owner (electric bus charging): All infrastructure owners (e.g., school district,
private fleet) of the electric bus charging equipment. If the infrastructure owner is the applicant,
the school district that the new buses will serve, or a private fleet entered in your application,
then you do not have to enter new infrastructure owner information as it is already included
within this form.
— Infrastructure Supplier (charging equipment only): All infrastructure suppliers from which
charging equipment was purchased (includes the installer of the infrastructure charging
equipment when they are also the charging equipment supplier).
— Infrastructure Installer:The organization that installed the charging equipment.
— Electrification as a Service (EaaS) Provider: Any organization that is paid by the selectee or
school district to manage charging infrastructure and is not otherwise listed in the Close
Out Form.
— Other Infrastructure Organization: All other eligible infrastructure organizations (e.g.,
organizations that perform trenching and wiring or project management; does not include the
charger installer if the charger is installed by the infrastructure charging equipment supplier).
— Telematics Contact: The organization responsible for supplying bus telematics data.
Organization Name: Name of the organization.
¦ Address: Address of the organization including city, state, county, and zip code.
¦ Contact Information: First and last name, title, business email, and business phone number of the
organization's contact.
Update Organization Contact: Checking this box will allow you to update any organization
contact fields.
Replace Organization Contact: Checking this box will delete all of the existing organization contact
entries, allowing you to add a new organization contact.
"Documents" Page
¦ Document Name: A unique name for the document that will be used to reference this document
within the form. Required documents include final invoices and proof of delivery (for example, a bill
of lading).
Document Description: This optional field can be used to enter any additional information about the
document and is limited to 250 characters.
Document Purpose (Choose all that apply): Indicate which of the following categories the document
applies to.
— New Bus: The replacement bus.
— Electric Bus Charging Equipment: Charging equipment for the replacement bus.
— Other Infrastructure Installation Costs: Other infrastructure costs for the replacement bus
(e.g., wiring, conduit, labor, project management).
Document Type: Select either Final Invoice or Proof of Delivery.
Apply [Final Invoice/Proof of Delivery] to All Buses: Select this button if the document applies to all
buses purchased with rebate funds.
-------
Apply [Final Invoice/Proof of Delivery] to all charging infrastructure: Select this button if the
document applies to all the infrastructure purchased with rebate funds.
Apply Final Invoice to all other infrastructure: Select this button if the final invoice applies to all the
other infrastructure costs purchased with rebate funds.
¦ Associated Purchaser: The purchaser of buses or infrastructure that is named in this document. The
associated purchaser can be an applicant organization, school district, existing bus owner, new bus
owner, private fleet, or infrastructure owner on the "Organizations" page.
¦ Associated Vendor: The vendor of buses or infrastructure that is named in this document. The
associated vendor can be an applicant organization, new bus dealer, private fleet, infrastructure
supplier, infrastructure installer, or other infrastructure organization on the "Organizations" page.
¦ Document Upload: Attach a file or scan of the relevant document.
— Allowed file types: *.pdf, *.png, *.jpeg, *.jpg
— Minimum file size: 1 KB
— Maximum file size: 5MB
"Buses" Page
Number of School Buses in Current Fleet: Total number of buses (of all types) in the current fleet.
Number of Electric School Buses in Current Fleet: Total number of electric buses in the
current fleet.
¦ Swap Existing Bus: Select this box if an existing bus provided in the application will be swapped for a
different existing bus.
¦ Exclude Bus: Select this box if the bus to be swapped in the application will be excluded from
the rebate.
¦ Existing Bus Owner:The owner of the existing bus must be selected from the drop-down list.
Existing Bus VIN, Fuel Type, GVWR, Model, Model Year, NCES District ID, Manufacturer, Average
Annual Fuel Consumption, Average Annual Mileage, Estimated Remaining Life,Annual Idling
Hours: These fields are prepopulated with information you entered on your Payment Request Form.
Existing Bus Odometer:The odometer reading of the existing bus to be replaced. If the exact reading
is unknown, provide an estimate.
Existing Bus EPA Vehicle Family: The 12-character alphanumeric EPA Vehicle Family name or 10- to
12-character CARB Executive Order ID. For instructions on where to find this value, see the "Existing
Bus Information" section of this guide.
¦ Replacement Process: Existing buses can be either scrapped, sold, or donated. Model year 2010
and older buses can only be scrapped. Model year 2011 and newer buses can be scrapped, sold, or
donated.
Scrap Yard Organization, Existing Bus Sold to. Existing Bus Donated to: organizations which
scrapped, purchased or received the existing bus.
Existing Bus Proof of Scrappage: Attach photos and letter for all scrapped buses. Photos should be
labeled with the last four digits of the VIN number and show the destroyed engine and chassis. Attach
a letter signed by a representative of the scrap yard/entity that performed the scrappage.
-------
— Allowed file types: *.pdf, *.png, *.jpeg, *.jpg
— Minimum file size: 1 KB
— Maximum file size: 5MB
¦ New Bus Owner: The name of the organization that will own the new bus.
¦ New Bus Service Provider: Please select the organization that is providing transportation services to
the school district stated within your award.
Bus Rebate Amount Received: The rebate received for this bus. This value is pulled from the Payment
Request Form.
Maximum Eligible Bus Rebate from Close Out Form: Prepopulated based on new bus fuel type,
new bus GVWR, and prioritization status of school district per the ?023 CSB Rebates Program Guide.
If this is a propane or CNG replacement bus, this value is only for a bus rebate, as a rebate is not
offered for infrastructure costs for CNG and propane buses. If you are swapping out an existing bus,
the amount of the rebate requested for this bus cannot exceed the rebate amount from your Payment
Request Form.
¦ Final Invoice: Select the final invoice document for the new bus from the drop-down list.
New Bus Purchase Price:The purchase price of the ordered replacement school bus, including tax and
any eligible training/consulting/warranty line item expenses associated with the individual bus in the
final invoice.
¦ Proof of Delivery: Select the document proving delivery (for example, a dated bill of lading) from the
drop-down list.
¦ New Bus Dealer: The entity selling the new bus that is listed on the final invoice.
New Bus VIN:The 17-digit Vehicle Identification Number for the bus delivered.
¦ New Bus Fuel Type: The fuel type used by the new bus.
¦ New Bus Manufacturer: Select the manufacturer of the new bus from the drop-down list. If the
manufacturer is not listed, select Other.
New Bus Manufacturer (Other):This field appears if Other is selected for New Bus Manufacturer.
¦ Shipping Cost Rebate Received: Rebate amount you received to cover the cost of shipping this bus
outside the continental United States.
¦ New Bus GVWR: Bus gross vehicle weight rating in pounds.
¦ New Bus Model: Model name of the new bus.
¦ Bus Shipping Costs: Actual shipping costs for this bus from the order document associated with
this bus.
Eligible Bus Shipping Rebate:The bus shipping rebate this bus is eligible for is based on the bus
shipping costs. If the bus shipping costs exceed the shipping cost rebate requested, then the bus
is eligible for a bus shipping cost rebate up to $20,000. If the bus shipping costs are less than the
shipping cost rebate requested, then the bus is eligible for the amount entered into the Bus Shipping
Costs field.
Shipping Cost Responsibility: If the bus shipping costs exceed the eligible bus shipping rebate, the
applicant is responsible for paying the amount displayed here.
-------
Replacement Bus Equipped with ADA-Compliant Wheelchair Lift?: Check this box if the
replacement bus has an ADA-compliant wheelchair lift.
— ADA-Compliance Rebate Received: Rebate received for ADA-compliant wheelchair lift costs in
the Payment Request Form.
— ADA-Compliance Costs: Purchase price for equipping the bus with an ADA-compliant
wheelchair lift.
— Eligible ADA-Compliance Rebate: The rebate this bus is eligible for is based on the ADA-
compliance costs entered. If these costs are more than the ADA-compliance rebate requested,
then the bus is eligible for the ADA-compliance rebate requested amount of $20,000. If the ADA-
compliance costs are less than the ADA-compliance rebate requested, then the bus is eligible for
the amount entered into the ADA-Compliance Costs field.
— ADA Cost Responsibility: The portion of the ADA-compliance costs that exceed the ADA-
compliance rebate received. The applicant is responsible for paying this amount.
— Total Eligible ADA and Shipping Rebate: The sum of (if applicable) the eligible bus shipping
rebate and the eligible ADA-compliance rebate.
New Bus EPA Vehicle Family: The 12-character alphanumeric EPA Vehicle Family name or 10- to
12-character CARB Executive Order ID. For instructions on where to find this value, see the "New Bus
Information" section of this guide.
¦ New Bus Delivery Date: Date that the new buses were delivered. If the new bus delivery date on the
final invoice or proof of delivery differs from the actual delivery date, check the box below: New Bus
Delivery Date is the actual delivery date and differs from the new bus delivery date listed within
the bill of lading (or other document).
¦ New Bus ModelYear: Model year of new bus.
Reason for Change of Bus Information: Provide an explanation if any new bus information has
changed from what was entered on the Payment Request Form.
New Bus Estimated Annual Mileage: Estimated annual miles the new bus will travel.
Estimated EV Bus Range: For electric buses only, the manufacturer's estimated range in miles for the
new bus.
Estimated Annual Idling Hours: Estimated annual idling hours for the new bus.
¦ EV Battery Capacity: For electric buses only, rated battery capacity of the bus in kilowatt-hours.
Equipped with Auxiliary Heater?: For electric buses only, select Yes if the new bus has an auxiliary
heater.
Capable of Bidirectional Charging?: For electric buses only, select Yes if the charger is capable of
two-way charging (e.g., grid-to-vehicle and vehicle-to-grid).
Photo of New Bus and VIN Documentation: Attach two photos for each bus: 1) a side view of the
entire bus, and 2) photo of the VIN plate. Include the last four digits of the VIN in the file name of
each photo.
¦ Battery Warranty Included?: Select Yes if there is a battery warranty included in the bus purchase.
¦ Number ofYears Covered: Number of years that the battery warranty covers.
¦ Miles Covered: Number of miles that the battery warranty covers.
-------
kWh of Gross Discharge Throughput: Kilowatt-hours of gross discharge throughput that the battery
warranty covers.
¦ Battery Warranty Documents: Document explaining conditions of the battery warranty.
Powertrain Warranty Included?: Select Yes if the bus purchase includes a powertrain warranty.
Number of Buses Requested (Application): Prepopulated from the information in your rebate
application.
Number of Buses Ordered (Payment Request): Prepopulated from the information in your Payment
Request Form.
Number of Buses Received (Close Out): Number of new buses on your Close Out Form.
Total Bus Costs from Payment Request: The sum of all the bus costs from the Payment
Request Form.
¦ Total Bus Costs (Actual): This calculated value is the sum of the new bus purchase price for all the
replacement buses received and included in the Close Out Form.
¦ Total Bus Rebate Received: This calculated value is the total rebate amount received for all the buses
ordered in the Payment Request Form.
Total Shipping Rebate Received: Total rebate funding received to cover shipping costs. This value
comes from your Payment Request Form.
Total Shipping Rebate Used (Actual): Amount of shipping rebate used to cover shipping costs.
¦ Total Shipping Costs (Actual):Total actual shipping costs entered in the Close Out Form.
Total Shipping Cost Responsibility: If total actual shipping costs exceed the total shipping rebate
received, the difference is the amount the applicant is responsible for.
¦ Total ADA Rebate Received: Total rebate received to pay for ADA-compliant features. This value comes
from your Payment Request Form.
¦ Total ADA Rebate Used (Actual): Amount of ADA rebate actually spent on accessibility features.
¦ Total ADA Costs (Actual): Total actual cost of ADA-compliant wheelchair lifts and associated expenses.
¦ Total ADA Cost Responsibility: If the actual total ADA costs exceed the total ADA rebate received,
the difference is the amount the applicant is responsible for.
Total Bus ADA and Shipping Reimbursement Owed: This warning appears if the actual shipping
and ADA costs provided on the Close Out Form indicate that you are eligible for less funding than the
rebate amount you were paid based on the approved Payment Request Form.
"Infrastructure" Page
Infrastructure Type: The charging infrastructure to be purchased for all electric buses. Level 2 Charger
and DC Fast Charger refer to the actual chargers and pedestals. Other eligible infrastructure costs
include construction, electrical work, site preparation, design and engineering, labor and
permitting, etc.
¦ Infrastructure Type (Other): The type of other eligible infrastructure costs found in the drop-down.
Other eligible infrastructure costs include construction, electrical work, site preparation, design and
engineering, labor and permitting, etc.
Other Eligible Infrastructure Cost: Total costs for the infrastructure in the Infrastructure Type
(Other) field.
-------
¦ Description of Work: A detailed description of the infrastructure-related work entered in the
Infrastructure Type (Other) field.
EVSE Maximum Output Power (kW): The rated maximum output power of the charger (in kilowatts).
For a Level 2 charger, this quantity should exceed 20 kW. For a DC fast charger, this quantity should not
be less than 20 kW.
Infrastructure Quantity: The number of chargers purchased at the same price. If multiple types of
chargers were purchased, each type must be entered individually. Additionally, if multiple chargers
of the same type were purchased at different costs, the chargers need to be entered as separate
infrastructure items.
¦ EVSE Manufacturer: The manufacturer of the charger is selected from a drop-down list.
¦ EVSE Manufacturer (Other): If the manufacturer is not an option in the drop-down list, select Other
and enter the name in this field.
¦ Infrastructure Cost per Charger: The cost of each charger for that specific infrastructure line item,
including installation cost if not listed separately.
¦ EVSE Model: The model name of the charger. If it is a Level 2 charger, the model name is listed on the
Energy Star certification.
Total Taxes and Other Fees: The total taxes and fees listed on the invoice.
EVSE Date of Manufacture:The date (in the format MM/DD/YYYY) that the EVSE was manufactured,
listed on the charger.
¦ Infrastructure Subtotal: This calculated field is the sum of infrastructure costs, taxes, and fees for this
infrastructure item.
EVSE Date of Installation: The date the infrastructure was installed in MM/DD/YYYY format.
¦ Total Cost Listed on Invoice: The total sum of infrastructure costs, installation, taxes, and fees for this
item, as listed on the invoice. This amount should match the infrastructure subtotal. If it does not, a
warning message will appear.
Cost Includes Installation: Check this box if the cost listed in the Infrastructure Cost per Charger
field includes installation.
Number of Plugs on EVSE: The number of plugs on each charger.
EVSE Capable of Bidirectional Charging?: Check this box if the charger is capable of bidirectional
charging (i.e., the EVSE can both receive energy and provide energy to an external load, such as
vehicle-to-grid charging, which supplies energy back to the electrical grid).
This Charger Is Energy Star Compliant: This field is only required for Level 2 chargers and should be
checked if all Level 2 chargers are Energy Star compliant.
This Charger or Infrastructure Materials Is Buy America Compliant: See 2023 Clean School Bus
Rebates Program Guide's Terms and Conditions and OTAQ's BABA Implementation Procedures
documem for information on Build America, Buy America requirements.
Infrastructure Installer: Select the organization that will do the installation work.
¦ Infrastructure Owner: Select the organization that owns the infrastructure.
¦ Electrification as a Service (EaaS Provider) Select the organization that is providing EaaS services to the
school district stated within your award.
-------
¦ Installation/Construction Address: The location, including the street address, city, state or territory,
zip code, and county, where the EVSE will be installed. Once the first infrastructure line item has been
added, this field will be pre-filied to match, but still editable.
Final Invoice: Upload the final invoice listing this infrastructure item.
¦ Proof of Delivery: Upload the proof of delivery document for this infrastructure item.
Infrastructure Vendor:
Photos of Charging Equipment and photo of equipment serial number(s): Upload a photo of the
installed EVSE and serial number.
Level 2 Charger Costs from Payment Request: The sum of all Level 2 charger costs entered on the
Payment Request Form.
¦ Level 2 Charger Costs (Actual):The sum of all Level 2 charger costs entered on the Close Out Form.
DC Fast Charger Costs from Payment Request: The sum of all DC fast charger costs entered on the
Payment Request Form.
¦ DC Fast Charger Costs (Actual):The sum of all DC fast charger costs entered on the Close Out Form.
Other Infrastructure Costs (Actual): The sum of all other eligible infrastructure costs entered on the
Close Out Form.
Total Infrastructure Costs from Payment Request: Total cost of all Level 2 chargers, DC fast
chargers, and other eligible infrastructure costs from your Payment Request Form.
¦ Total Infrastructure Costs (Actual): Total costs entered in the Close Out Form for Level 2 chargers,
DC fast chargers, and other eligible infrastructure costs.
Total Infrastructure Rebate Received:Total infrastructure rebate received based on your Payment
Request Form.
"Funding" Page
Existing BusVIN: 17-digit Vehicle Identification Number of the existing bus to be replaced.
Existing Bus Fuel Type: Fuel type of existing bus to be replaced.
¦ New Bus Fuel Type: Fuel type of the new bus that will replace this existing bus.
¦ Shipping Rebate Used: If applicable, this field shows the amount of shipping rebate that was used to
cover shipping costs to outside the continental United States.
¦ ADA Rebate Used: If applicable, this field shows the amount of ADA rebate funds used to purchase
ADA-compliant accessibility features.
¦ New Bus Purchase Price: New bus purchase price you entered for this bus on the "Buses" page.
Eligible Bus and Infrastructure Rebate Amount: The maximum eligible bus rebate from the "Buses"
page of the Close Out Form.
Funding Allocation forThis Bus: Initially, this amount is what you allocated for this bus in the
Payment Request Form. You may change this amount. The amount entered cannot be more than the
lesser of the new bus purchase price or the eligible bus and infrastructure rebate amount. For
electric buses, any remaining unallocated rebate amount for this bus will be available for eligible
infrastructure costs.
-------
Remaining Rebate Amount forThis Bus: The portion of this bus's rebate that has not been allocated
to this bus. It is the difference between (1) the lesser of the new bus purchase price or the eligible bus
and infrastructure rebate amount and (2) the funding allocation for this bus.
Remaining Rebate Amount for Infrastructure: This amount is the eligible bus and infrastructure
rebate amount minus the funding allocation for this bus.
Total Rebate Amount Received: The total available rebate funding for bus(es) and infrastructure from
your Payment Request Form.
Rebate Amount Allocated to All Buses: The sum of funding allocation for all buses.
¦ Total Bus Costs: The sum of new bus purchase price for all buses.
Total Remaining Rebate Amount for All Buses: Total rebate amount received minus the rebate
amount allocated to all buses.
Non-EPA Funding Type: Type of non-EPA funding. Options include federal, state, city, utility make-
ready, nonprofit, and other.
Non-EPA Funding Source: Source of non-EPA funding.
Non-EPA Funding Amount: Dollar amount of non-EPA funding.
Total Non-EPA Funding Acquired: The sum of all non-EPA funding sources.
Interest Earned on CSB Rebate: select yes if any interest was earned on CSB rebate funding and
select "No" if funds did not earn any interest.
Non-EPA Bus Funding Not Accounted For: This calculated number shows the amount of non-EPA
funding that is the applicant's responsibility but is not yet accounted for in the list of funding source
amounts you entered above. When all funding source amounts are accounted for, this number will be
$0.00. If too much is accounted for, this number will be negative; if not all funding source amounts
have been accounted for, this number will be positive.
Unallocated Bus Rebate Eligible for Infrastructure: This is the amount of unallocated bus rebate
that could be used for eligible infrastructure costs. It does not include unallocated CNG or propane bus
rebate funding (if applicable).
Funding Allocation for All Eligible Infrastructure Costs: Enter the rebate amount you would like
to allocate for eligible infrastructure costs. You cannot allocate more than the lesser amount of the
Unallocated Bus Rebate Eligible for Infrastructure and Total Eligible Infrastructure Costs fields.
Any unallocated amount will reduce the amount of your rebate.
Total Infrastructure Non-EPA Funding Acquired: The sum of all non-EPA funding amounts entered in
the "Non-EPA Clean School Bus Infrastructure Funding Information" section of this page.
Non-EPA Infrastructure Funding Not Accounted For: This calculated number shows the amount of
non-EPA funding that is the applicant's responsibility but is not yet accounted for in the list of funding
source amounts you entered above. When all funding source amounts are accounted for, this number
will be $0.00. If too much is accounted for, this number will be negative, and if all funding source
amounts have not been accounted for, this number will be positive.
Infrastructure Reimbursement Owed to EPA: Amount of excess EPA rebate that you may need to
pay back to the EPA based on this Close Out Form.
Total Eligible Replacement Bus and Infrastructure Rebate Requested in Payment Request: Total
rebate amount from your Payment Request Form.
-------
Total Allocated Rebate Amount: This is the total rebate funding you have allocated for buses and
eligible infrastructure.
Total Eligible Replacement Bus and Infrastructure Rebate Requested in Close Out: After
allocations made above.
Total Unallocated Requested Rebate Amount: This is the amount of rebate funding that has not
been allocated for buses or infrastructure. Your eligible rebate will be reduced by this amount.
¦ Total Costs for Buses and Infrastructure: The sum of actual bus and infrastructure costs entered in
the Close Out Form.
Total Applicant Cost Responsibility: The sum of actual bus and infrastructure costs minus the total
eligible replacement bus and infrastructure rebate requested in close out.
Build America, Buy America Compliance" Page
Is infrastructure used in this project BABA compliant? On this page, you confirm whether the
infrastructure identified on the "Infrastructure" page (for all infrastructure materials and chargers) will
be Build America, Buy America Act compliant.
Telematics" Page
¦ Telematics Data: Check this box if you are willing to provide bus or EVSE telematics data to the EPA or
its partners for research purposes.
¦ Telematic Contact Selection: To identify your telematics contact person, select either Use Primary
Contact, Use Alternate Contact, or Use Telematics Contact.
Signature" Page
¦ Total Bus Costs (Actual): The sum of all actual bus costs.
¦ Total Infrastructure Costs (Actual): The sum of all actual costs of infrastructure and associated
expenses.
¦ Total Shipping and ADA Costs: For applicants outside the continental United States, this amount is
the sum of all bus shipping costs and costs to install ADA-compliant wheelchair lifts.
¦ Total Combined Costs: The sum of total bus costs (actual), total infrastructure costs (actual), and total
Shipping and ADA costs, if applicable.
Total Applicant Responsibility: The calculated difference between total combined costs and total
combined rebate received. If the value is negative, the amount must be reimbursed to the EPA.
"Rebate Received" Fields
— Total Bus Rebate Received: Total rebate received to purchase buses.
— Total Shipping Rebate Received: If applicable, amount received to cover bus shipping costs.
— Total ADA Rebate Received: If applicable, amount received to cover the cost of ADA-compliant
wheelchair lifts.
— Total Infrastructure Rebate Received: Total rebate amount received to cover infrastructure
materials and associated costs.
— Total Combined Rebate Received: The sum of total bus rebate received and, if applicable, total
infrastructure rebate received, total shipping rebate received, and total ADA rebate received.
-------
"Rebate Used" Fields
— Total Bus Rebate Used (Actual):The sum of all actual funding allocated to buses.
— Total Shipping Rebate Used (Actual): If applicable, actual amount that was used toward
shipping costs.
— Total ADA Rebate Used (Actual): If applicable, actual amount used to pay for ADA-compliant
wheelchair lifts.
— Total Infrastructure Rebate Used (Actual): The sum of all actual funding allocated to
infrastructure equipment and associated costs.
Total Combined Rebate Used (Actual): The sum of total bus rebate used (actual) and, if applicable,
total shipping rebate used (actual), total ADA rebate used (actual), and total infrastructure rebate used
(actual).
¦ Total Owed Back to EPA: This field appears if the actual eligible costs entered on the Close Out Form
are less than the sum of the total rebate amount received and any additional non-EPA funding you
received. Additional actions will be necessary after submittal and review of the Close Out Form to
settle this balance. You must refund this amount back to the EPA.
-------
Appendix B: Printable List of Fields
This appendix lists fields that make up the Close Out Form. When filling out the Form, you will need to supply
some, or all of the information listed in this appendix. Required fields are marked with an asterisk.
Note that this is only a printable reference. You will need to fill out the actual Close Out Form using the online
dashboard described in this guide. There are other fields that are Form-generated that are not listed here, such
as summary fields that total the information entered, and fields that indicate a reimbursement is needed.
Applicant Info (Page 2)
Organization County*
Applicant Primary Contact
This information is prepopulated but can be edited if you need to make changes.
Primary Contact First Name* Primary Contact Last Name*
Primary Contact Title* Primary Contact Business Phone Number*
Primary Contact Business Email*
Applicant Alternate Contact
Alternate Contact First Name Alternate Contact Last Name
Alternate Contact Title Alternate Contact Business Phone Number
Alternate Contact Business Email
School District Info (Page 3)
This information is prepopulated but can be edited if you need to make changes.
School District Contact Information
First Name* Business Email*
Last Name* Business Phone Number*
Title*
-------
Organizations (Page 4)
The fields below will be filled out for each organization. Copy this page as needed for additional organizations.
General Information
Organization Type* (check all that apply)
Scrap Yard (existing bus) Organization Name*
Donee (existing bus)
Purchaser (existing bus)
Existing Bus Owner
New Bus Owner
Private Fleet (existing or new buses)
New Bus Dealer
Infrastructure Owner (electric bus charging)
Infrastructure Supplier (charging equipment only)
Infrastructure Installer
Other Infrastructure Organization
Telematics Contact
Electrification as a Service (EaaS provider)
Address
Organization Address 1 *
Organization City*
Organization Address 2*
Organization State or Territory*
Organization County* Organization Zip*
Contact Information
This information is prepopulated but can be edited if you need to make changes.
Organization Contact First Name* Organization Contact Business Email*
Organization Contact Last Name* Organization Contact Business Phone Number*
Organization Contact Title*
-------
Documents (Page 5)
Document Information
The fields below will be filled out for each document. Copy this page as needed for additional documents.
Document Name* Document Description
Document Purpose (Choose all that apply)*
New Bus Document Type*
Electric Bus Charging Equipment
Other Infrastructure Installation Costs
Does this document contain information for all buses? If yes, select Apply [Document Type] to all buses.
Does this document contain information for all charging infrastructure items? If yes, select Apply [Document Type] to all
charging infrastructure.
Does this document contain information for all other infrastructure items? If yes, select Apply [Document Type] to all other
infrastructure.
Associated Purchaser*
Document Upload*
Allowed file types: *.pdf, *.png, *.jpeg, *.jpg
Minimum file size: 1 KB
Maximum file size: 5MB
Buses (Page 6)
General Information
Number of School Buses in Current Fleet*
Bus Information
Associated Vendor*
Number of Electric School Buses in Current Fleet*
Existing Bus Odometer*
Existing Bus EPA Vehicle Family*
-------
Swap or Exclude Existing Bus
Would you like to swap this existing bus and choose a different bus to be replaced instead?
When swapping an existing bus, fill out the fields below.
Reason for Swapping Existing Bus*
No longer own bus
Bus no longer in service
Another bus is better option
Contracted with another bus provider
_ Other
Reason for Swapping Existing Bus (Other)
Would you like to exclude this existing bus from the rebate?
If you are not swapping or excluding this bus, the information below is prepopulated.
Existing Bus Information
Existing Bus Owner*
Existing BusVIN* Existing Bus NCES District ID*
Existing Bus Fuel Type* Existing Bus Model* Existing Bus Manufacturer*
Existing Bus GVWR* Existing Bus Model Year*
Existing Bus EPA Vehicle Family
Existing Bus Average Annual Fuel Consumption* Estimated Remaining Life*
Existing Bus Average Annual Mileage* Existing Bus Annual Idling Hours*
Existing Bus Title (if swapped)
File Upload: Existing BusTitle*
Allowed file types: *.pdf, *.png, *.jpeg, *.jpg
Minimum file size: 1KB
Maximum file size: 5MB
-------
Replacement Process*
Scrapped
Scrap Yard Organization (if scrapped)*
_ Sold
Donated Existing Bus Sold To (if sold)*
Existing Bus Donated To (if donated)*
File Upload: Existing Bus Proof of Scrappage (if scrapped)*
Allowed file types: *.pdf, *.png, *.jpeg, *.jpg
Minimum file size: 1KB
Maximum file size: 5MB
New Bus Information
New Bus Owner*
New Bus Service Provider*
Proof of Delivery*
Final Invoice* New Bus Purchase Price*
New Bus Dealer* New Bus Fuel Type*
New BusVIN*
New Bus Manufacturer*
New Bus GVWR* New Bus Model* Bus Shipping Costs*
Replacement Bus Equipped with ADA-Compliant Wheelchair Lift
ADA-Compliance Costs* New Bus EPA Vehicle Family*
New Bus Delivery Date* New Bus Model Year*
New Bus Delivery Date is the actual delivery date and differs from the new bus delivery dates listed within the bill of
lading (or other document).
Reason for Change of Bus Information (if changed)
-------
New Bus Estimated Annual Mileage* Estimated EV Bus Range*
Estimated Annual Idling Hours*
EV Battery Capacity*
Equipped with Auxiliary Heater?*
Capable of Bidirectional Charging?*
File Upload: Photo of New Bus andVIN Documentation*
Allowed file types: *.pdf, *.png, *.jpeg, *.jpg
Minimum file size: 1KB
Maximum file size: 5MB
Battery Warranty
Only necessary if the purchase includes a battery warranty.
Battery Warranty Included?
File Upload: Battery Warranty Documents
Allowed file types: *.pdf, *.png, *.jpeg, *.jpg
Minimum file size: 1KB
Maximum file size: 5MB
Powertrain Warranty
Only necessary if the purchase includes a powertrain warranty.
Powertrain Warranty Included? Number of Years Covered
Miles Covered
File Upload: Powertrain Warranty Documents
Allowed file types: *.pdf, *.png, *.jpeg, *.jpg
Minimum file size: 1KB
Maximum file size: 5MB
Yes
No
Number of Years Covered
Miles Covered
kWh of Gross Discharge Throughput
-------
Infrastructure (Page 7)
Infrastructure Information (if applicable)
Infrastructure Type*
Level 2 Charger
DC Fast Charger
Other Eligible Infrastructure Costs
For Level 2 chargers or DC fast chargers:
EVSE Maximum Output Power (kW)*
Infrastructure Quantity*
EVSE Manufacturer*
Infrastructure Cost per Charger*
EVSE Model*
Total Taxes and Other Fees*
EVSE Date of Manufacture*
EVSE Date of Installation*
Total Cost Listed on Invoice*
Number of Plugs on EVSE*
EVSE Capable of Bidirectional Charging?
This Charger Is Energy Star Compliant* (required if Level 2 charger)
This Charger or Infrastructure Materials Is Buy America Compliant
For other eligible infrastructure costs:
Infrastructure Type (Other)* Other Eligible Infrastructure Cost*
Total Taxes and Other Fees*
Description of Work*
Total Cost Listed on Invoice*
-------
For all infrastructure:
Infrastructure Installer*
Infrastructure Owner*
Installation/Construction Address
Street Address*
City* County*
State or Territory* Zip*
Documents and Photos
Final Invoice*
Proof of Delivery*
File Upload: Photo of Charging Equipment*
Allowed file types: *.pdf, *.png, *.jpeg, *.jpg
Minimum file size: 1KB
Maximum file size: 5MB
Funding (Page 8)
Bus Funding Allocations
Copy this section as needed for each bus.
Funding Allocation forThis Bus*
Non-EPA Clean School Bus Funding Information
Copy this section as needed for each source of non-EPA clean school bus funding.
Non-EPA Funding Type* Non-EPA Funding Source* Non-EPA Funding Amount*
Infrastructure Award Allocations
Funding Allocation for All Eligible Infrastructure Costs*
Non-EPA Clean School Bus Infrastructure Funding Information
Non-EPA Funding Type* Source of Additional Non-EPA Funding* Non-EPA Funding Amount*
-------
Build America, Buy America Compliance (Page 9)
Is infrastructure used in this project BABA compliant? *
Yes, all project infrastructure meets BABA requirements, including non-EPA funded infrastructure for which the purchasing
process was initited after Aug 8, 2025
Yes, I am using a BABA Waiver for some or all project infrastructure
No BABA does not apply to this project infrastructure
If Yes with a Waiver:
Please select the approved waiver(s) that applies to your project
Multi-Agency General Applicability Public Interest Waiver for Indian Tribes
EPA Electronic Vehicle Chargers Product Waiver of Section 70914(a) of P L. 117-58, Build America, Buy America Act
EPA De Minimis General Applicability Waiver of Section 70914 of PL. 117-58, Build America, Buy America Act
EPA Small Project General Applicability Waiver of Section 70914(a) of PL. 117-58, Build America, Buy America Act
Multi-Agency General Applicability Public Interest Waiver for Pacific Island Territories
Approved Project-Specific Waiver
Project-Specific Waiver
Project specific Waiver Name
Date approved
If answer is "No BABA does not apply to this project infrastructure"
Please answer
Fueling infrastructure for the EPA-funded buses is not part of the same project as the EPA-funded buses based on the
Purpose, Time, and Place test
The purchasing process for the charging or other fueling infrastructure in this school bus project was initiated prior to
August 8, 2025
Telematics (Page 10)
EPA or its partners may contact me about participating in research opportunities to provide bus or EVSE telematics data
that could inform future transportation work.
Signature (Page 11)
Review summary information, sign, and confirm signature in checkbox
------- |