Submit an Application - Contact Information

Contact Information:

All communications from the Administrator will be directed to the information provided below.

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The Administrator requires your SSN, as your incentive payment may be taxable income.

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The Administrator requires your TIN, as your incentive payment may be taxable income.

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Vehicle Information:

Please enter your 17-digit Vehicle Identification Number (VIN):* questions

Please Note: To be eligible to receive payment as part of the Mercedes-Benz USA Emission Modification Program (“EMP”) Incentive for having the Approved Emission Modification (“AEM”) installed on your vehicle, the AEM must’ve been installed by an authorized Mercedes-Benz Dealer on or after January 1, 2023.