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GENERAL MOTORS MOBILITY REIMBURSEMENT APPLICATION

REIMBURSEMENT PROGRAM FEATURING ONSTARAND CONNECTED SERVICESP roviding the capability andconfi dence to live a life in , COMPLETE, AND RETURN FORMGENERAL MOTORS MOBILITY REIMBURSEMENT APPLICATIONPAGE 2 of 2 APPLICATIONPLEASE KEEP A COPY OF THE APPLICATION AND ALL SUPPORTING DOCUMENTS FOR YOUR FILES. This claim and any payment made under this claim are subject to the O cial Program Rules and Guidelines that are in e ect from 10/01/19 to 1/02/21 and have been made available to all authorized GM dealers. GENERAL MOTORS reserves the right to modify or terminate this program without REQUEST NUMBER FOR INTERNAL USE ONLYTake your adapted vehicle and APPLICATION to your GM dealer. Have your GM dealer representative sign the APPLICATION .

Chevrolet, Buick, Cadillac or GMC vehicle can receive up to $1,0001 in reimbursement ($1,200 on Chevy Express and GMC Savana) toward the cost of eligible adaptive equipment installed (or reinstalled) on their new vehicle. ... 10/9/2019 1:03:59 PM ...

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