| Invoice # | Company Name | Company Contact | Company Phone | Company Email | Rebate Status | Safety Inspection Date | Purchase/Invoice Date | Safety Inspector’s Full Name | Type of Installation | How many rebates would you like to claim? | Total | Total | Installation Type | Appliance Type | Brand | Model # | Model # | Serial Number | Installation Date | Upload Receipt | Appliance Type | Brand | Model # | Model # | Serial Number | Installation Date | Upload Receipt | Appliance Type | Brand | Model # | Model # | Serial Number | Installation Date | Upload Receipt | Propane Company Name | Propane Marketer Name | Mailing Address | Email Address | Phone Number | Customer / Recipient Name | Customer / Recipient Phone Number | Customer / Recipient Email | Customer / Recipient Address | Customer / Recipient Installation Address | Required Materials | Upload Proof of Purchase: | Name of Builder/Contractor | Upload Spec Sheet for Manufactured Home | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2024-99467392 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 04/04/2025 | 04/04/2025 | CURTIS HUNTER | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Tankless Water Heater ($200.00) | RINNAI | RE199EP | SH.UA-114125 | 04/04/2025 | PHILLIPS.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | HANNAH PHILLIPS | (229) 854-2673 | 4817 COACH LIGHT COURT ALBANY, Georgia 31721 Map It | 4817 COACH LIGHT COURT ALBANY, Georgia 31721 Map It | The following materials are required to complete your application:
| PHILLIPS1.pdf | |||||||||||||||||||||||
| 2024-68374177 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 04/07/2025 | 04/07/2025 | CURTIS HUNTER | Replacement or New Appliance | 2 | $400.00 | 400 | Replacement Installation | Tankless Water Heater ($200.00) | RINNAI | RE160EP | SA.UA-001406 | 04/07/2025 | MARTIN.pdf | Tankless Water Heater ($200.00) | RINNAI | RL75EP | PC.CA-043147 | 04/07/2025 | MARTIN1.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | DAHPINE MARTIN | (229) 828-2011 | 17896 HWY 41 NORTH WESTON, Georgia 31832 Map It | 17896 HWY 41 NORTH WESTON, Georgia 31832 Map It | The following materials are required to complete your application:
| MARTIN2.pdf | |||||||||||||||||
| 2024-18458206 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 04/08/2025 | 04/08/2025 | ROYCE HUNTER | Replacement or New Appliance | 2 | $400.00 | 400 | Replacement Installation | Tankless Water Heater ($200.00) | RINNAI | RX130IP | RM.BA-137797 | 04/08/2025 | WORTHY.pdf | Tankless Water Heater ($200.00) | RINNAI | RX130IP | RM.BA-138005 | 04/08/2025 | WORTHY1.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | SARAH WORTHY | (229) 886-4372 | 468 WIREGRASS WAY ALBANY, Georgia 31721 Map It | 468 WIREGRASS WAY ALBANY, Georgia 31721 Map It | The following materials are required to complete your application:
| WORTHY2.pdf | |||||||||||||||||
| 2024-49429024 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 04/04/2025 | 04/04/2025 | DAVID TIMMERMAN | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Storage-Type Water Heater ($200.00) | GE | GP50T08BXR | VT600504 | 04/04/2025 | LANIER.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | CATHY & DAVID LANIER | (229) 894-8466 | 2705 FORRESTER ROAD ALBANY, Georgia 31721 Map It | 2705 FORRESTER ROAD ALBANY, Georgia 31721 Map It | The following materials are required to complete your application:
| LANIER1.pdf | |||||||||||||||||||||||
| 2024-15168986 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 04/05/2025 | 04/05/2025 | MIKE BURLESON | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Storage-Type Water Heater ($200.00) | BRADFORD WHITE | RG250T6X | AJ54055147 | 04/05/2025 | PATEL.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | PIYUSHKUMAR PATEL | (478) 714-4189 | 159 QUAIL VALLEY DR LEESBURG, Georgia 31763 Map It | 159 QUAIL VALLEY DR LEESBURG, Georgia 31763 Map It | The following materials are required to complete your application:
| PATEL1.pdf | |||||||||||||||||||||||
| 2024-18190931 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 04/01/2025 | 04/01/2025 | CURTIS HUNTER | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Tankless Water Heater ($200.00) | RINNAI | RX180IN/P | SE.BA-081521 | 04/01/2025 | GASHWILER.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | ALAN GASHWILER | (252) 497-0390 | 161 WINCHESTER DR LEESBURG, Georgia 31763 Map It | 161 WINCHESTER DR LEESBURG, Georgia 31763 Map It | The following materials are required to complete your application:
| GASHWILER1.pdf | |||||||||||||||||||||||
| 2024-6249462 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 04/03/2025 | 04/03/2025 | ROYCE HUNTER | Replacement or New Appliance | 1 | $200.00 | 200 | New Installation | Tankless Water Heater ($200.00) | RINNAI | RX180IN/P | SJ.BA-149741 | 04/03/2025 | THOMPSON.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | JESSE & MARY THOMPSON | (229) 343-6001 | 188 WINNSTEAD DR LEESBURG, Georgia 31763 Map It | 188 WINNSTEAD DR LEESBURG, Georgia 31763 Map It | The following materials are required to complete your application:
| THOMPSON1.pdf | |||||||||||||||||||||||
| 2024-21220607 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 04/01/2025 | 04/01/2025 | TY BROWN | New Construction | 1 | $200.00 | 200 | Tankless Water Heater ($200.00) | RINNAI | RL75IP | LK.UA-078318 | 04/01/2025 | MERRITT.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | SHAW MERRITT CONSTRUCTION | (229) 291-8510 | 108 STORNOWAY DR LEESBURG, Georgia 31763 Map It | 108 STORNOWAY DR LEESBURG, Georgia 31763 Map It | The following materials are required to complete your application:
| SHAW MERRITT CONSTRUCTION | ||||||||||||||||||||||||
| 2024-51908888 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 04/02/2025 | 04/02/2025 | MIKE BURLESON | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Tankless Water Heater ($200.00) | RINNAI | RL75EP | PC.CA-043143 | 04/02/2025 | MONTGOMERY.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | JAMES MONTGOMERY | (229) 698-2158 | 2255 SASSER HEROD RD SASSER, Georgia 39885 Map It | 2255 SASSER HEROD RD SASSER, Georgia 39885 Map It | The following materials are required to complete your application:
| MONTGOMERY1.pdf | |||||||||||||||||||||||
| 2024-54709403 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Payment Sent | 04/08/2025 | 04/08/2025 | Alex Cash | Replacement or New Appliance | 1 | $300.00 | 300 | Conversion | Furnace or Gas Pack ($300.00) | Tempstar | N92M5N0801716A1 | A233658296 | 04/08/2025 | img04112025_0004.pdf | Folger Gas | Stacy Mullinax | 4955 Appalachian Highway Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | Shahab Fad Renovation Spot LLC | (404) 904-7106 | Email hidden; Javascript is required. | Big Valley Drive Lot # 50 Morganton, Georgia 30560 Map It | 140 Progress Cir Ste. # 7 Blue Ridge, Georgia 30513 Map It | The following materials are required to complete your application:
| img04112025_0005.pdf | ||||||||||||||||||||||
| 2024-4458889 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Payment Sent | 04/08/2025 | 04/08/2025 | Brian Bradley | Replacement or New Appliance | 1 | $200.00 | 200 | Conversion | Tankless Water Heater ($200.00) | Rinnai | RXP199 | RLBA124311 | 04/08/2025 | img04112025_0006.pdf | Folger Gas | Stacy Mullinax | 4955 Appalachian Highway Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | Charles Anderson | (706) 889-4756 | Email hidden; Javascript is required. | 791 Reserve Rd Blarisville, Georgia 30512 Map It | PO Box 382 Blairsville, Georgia 30512 Map It | The following materials are required to complete your application:
| img04112025_00061.pdf | ||||||||||||||||||||||
| 2024-21148731 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Payment Sent | 04/09/2025 | 04/09/2025 | Mathew ray | Replacement or New Appliance | 2 | $0.00 | 0 | Replacement Installation | rinnai | rx199in | sm.ba-214810 | 04/09/2025 | 2077_250430161939_001.pdf | rinnai | rx180in | se.ba-068540 | 04/09/2025 | 1882_250414081140_0011.pdf | Conger Lp gas | Monty Hall | 2310 -B Hwy 84 West 2310- B hwy 84 west Valdosta, Georgia 31601 Map It | Email hidden; Javascript is required. | (229) 469-4250 | Dixon Taylor | (229) 460-2894 | Email hidden; Javascript is required. | 4561 amelia cir hahira, Georgia 31635 Map It | 4561 amelia cir hahira, Georgia 31635 Map It | The following materials are required to complete your application:
| 1882_250414081140_0012.pdf | ||||||||||||||||||
| 2024-11769099 | Webb Brothers Propane, Inc | Kristy Gamble | (229) 382-0789 | Email hidden; Javascript is required. | Payment Sent | 04/08/2025 | 04/08/2025 | ROBERT COTHREN | Replacement or New Appliance | 1 | $200.00 | 200 | Conversion | Tankless Water Heater ($200.00) | RINNAI | RE180EP | SB.UA-013315 | 04/08/2025 | ELIZABETH-MCARTHY.pdf | Webb Brothers Propane, Inc | MICHAEL WEBB | PO Drawer 7269 3615 Hwy 82 W Tifton, Georgia 31793 Map It | Email hidden; Javascript is required. | (229) 382-0789 | ELIZABETH MCARTHY | (229) 402-5330 | 117 SPRINGHILL DR W TIFTON, Georgia 31793 Map It | 117 SPRINGHILL DR W TIFTON, Georgia 31793 Map It | The following materials are required to complete your application:
| ELIZABETH-MCARTHY1.pdf | |||||||||||||||||||||||
| 2024-19778468 | Folger Gas, LLC | Jessica Dills | (706) 367-8782 | Email hidden; Javascript is required. | Payment Sent | 04/10/2025 | 04/10/2025 | Kevin Smoot | New Construction | 1 | $200.00 | 200 | Tankless Water Heater ($200.00) | Navian | NPE-240A2 | 2087B2490562048 | 04/10/2025 | andyjenkinsrebate.pdf | Folger Gas, LLC | Jessica Dills | 1950 Bill Wright Rd Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Andy Jenkins | (706) 367-8782 | Email hidden; Javascript is required. | 1950 Bill Wright Rd Jefferson, Georgia 30549 Map It | 496 Maddox Farm Rd Jefferson, Georgia 30549 Map It | The following materials are required to complete your application:
| Andy Jenkins | |||||||||||||||||||||||
| 2024-38886895 | Folger Gas, LLC | Jessica Dills | (706) 367-8782 | Email hidden; Javascript is required. | Payment Sent | 04/11/2025 | 04/11/2025 | Kevin Smoot | New Construction | 1 | $300.00 | 300 | Furnace or Gas Pack ($300.00) | Trane | S9X1B06044PSBBA | 24495Y66JG | 04/11/2025 | collinlewisrebate.pdf | Folger Gas, LLC | Jessica Dills | 1950 Bill Wright Rd Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Collin Lewis | (706) 367-8782 | Email hidden; Javascript is required. | 1950 Bill Wright Rd Jefferson, Georgia 30549 Map It | 718 Hubert Pittman Rd Pendergrass, Georgia 30567 Map It | The following materials are required to complete your application:
| Collin Lewis | |||||||||||||||||||||||
| 2024-13587451 | Barfield Gas Company, Inc. | Michael Davis | (229) 896-4828 | Email hidden; Javascript is required. | Payment Sent | 03/14/2025 | 03/14/2025 | Caleb Harnage | Replacement or New Appliance | 1 | $200.00 | 200 | New Installation | Tankless Water Heater ($200.00) | RINNAI | RE199e | SM.UA-177483 | 03/14/2025 | J.HOLLOWAY-56064.pdf | Barfield Gas Company | Michael Davis | PO BOX 990 Adel, Georgia 31620 Map It | Email hidden; Javascript is required. | (229) 896-4828 | Jeremy Holloway | (229) 561-0681 | Jeremy Holloway 5378 Val Del Rd Hahira, Georgia 31632 Map It | Jeremy Holloway 5378 Val Del Rd Hahira, Georgia 31632 Map It | The following materials are required to complete your application:
| J.HOLLOWAY-560641.pdf | |||||||||||||||||||||||
| 2024-10210606 | Webb Brothers Propane, Inc | Kristy Gamble | (229) 382-0789 | Email hidden; Javascript is required. | Payment Sent | 04/08/2025 | 03/18/2025 | MICHAEL WEBB | New Construction | 1 | $200.00 | 200 | Tankless Water Heater ($200.00) | RINNAI | RE199EP | SL.UA-172992 | 04/08/2025 | CHAVEZ.pdf | Webb Brothers Propane, Inc | MICHAEL WEBB | PO Drawer 7269 3615 Hwy 82 W Tifton, Georgia 31793 Map It | Email hidden; Javascript is required. | (229) 382-0789 | JUANITA CHAVEZ | (229) 339-3473 | 2497 BROOKFIELD LENOX RD TIFTON, Georgia 31794 Map It | 2497 BROOKFIELD LENOX RD TIFTON, Georgia 31794 Map It | The following materials are required to complete your application:
| SELF | ||||||||||||||||||||||||
| 2024-14307495 | Webb Brothers Propane, Inc | Kristy Gamble | (229) 382-0789 | Email hidden; Javascript is required. | Payment Sent | 04/07/2025 | 04/07/2025 | ROBERT COTHREN | Replacement or New Appliance | 1 | $200.00 | 200 | Conversion | Tankless Water Heater ($200.00) | NAVIEN | NPE-21052 | 2084B2392689366 | 04/07/2025 | CHASE-LOTT.pdf | Webb Brothers Propane, Inc | MICHAEL WEBB | PO Drawer 7269 3615 Hwy 82 W Tifton, Georgia 31793 Map It | Email hidden; Javascript is required. | (229) 382-0789 | CHASE LOTT | (229) 891-8607 | 269 OLD TYTY RD TIFTON, Georgia 31793 Map It | 269 OLD TYTY RD TIFTON, Georgia 31793 Map It | The following materials are required to complete your application:
| CHASE-LOTT1.pdf | |||||||||||||||||||||||
| 2024-18104222 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Payment Sent | 04/10/2025 | 04/10/2025 | Donald Alford | Replacement or New Appliance | 1 | $400.00 | 400 | New Installation | rinnai | rep160ep | 119885 | 04/10/2025 | 1911_250415101606_001.pdf | Conger Lp gas | Monty Hall | 2310 -B Hwy 84 West 2310- B hwy 84 west Valdosta, Georgia 31601 Map It | Email hidden; Javascript is required. | (229) 469-4250 | Owens Vinyl | (229) 482-3375 | Email hidden; Javascript is required. | 14 Murray Blvd lakeland, Georgia 31635 Map It | 14 Murray Blvd lakeland, Georgia 31635 Map It | The following materials are required to complete your application:
| 1911_250415101606_0011.pdf | |||||||||||||||||||||||
| 2024-13962164 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Payment Sent | 04/10/2025 | 04/10/2025 | Donald Alford | Replacement or New Appliance | 1 | $400.00 | 400 | New Installation | rinnai | rep160ep | pk.ua-113441 | 04/10/2025 | 1913_250415101706_001.pdf | Conger Lp gas | Monty Hall | 2310 -B Hwy 84 West 2310- B hwy 84 west Valdosta, Georgia 31601 Map It | Email hidden; Javascript is required. | (229) 469-4250 | Owens Vinyl | (229) 482-3375 | Email hidden; Javascript is required. | 14 Murray Blvd lakeland, Georgia 31635 Map It | 14 Murray Blvd lakeland, Georgia 31635 Map It | The following materials are required to complete your application:
| 1899_250415074408_0011.pdf | |||||||||||||||||||||||
| 2024-23762651 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Payment Sent | 04/10/2025 | 04/10/2025 | Donald Alford | Replacement or New Appliance | 1 | $400.00 | 400 | New Installation | rinnai | rep160ep | pk-ua-113416 | 04/10/2025 | 1914_250415101730_001.pdf | Conger Lp gas | Monty Hall | 2310 -B Hwy 84 West 2310- B hwy 84 west Valdosta, Georgia 31601 Map It | Email hidden; Javascript is required. | (226) 469-4250 | Owens Vinyl | (229) 482-3375 | Email hidden; Javascript is required. | 14 Murray Blvd lakeland, Georgia 31635 Map It | 14 Murray Blvd lakeland, Georgia 31635 Map It | The following materials are required to complete your application:
| 1914_250415101730_0011.pdf | |||||||||||||||||||||||
| 2024-13909733 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 04/04/2025 | 04/04/2025 | RICKY HUIRAS | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Storage-Type Water Heater ($200.00) | GE | GP50T08BXR01 | VT600506C | 04/04/2025 | MURCHLAND.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | PAUL MURCHLAND | (434) 906-1699 | 106 WAX MYRTLE DR ALBANY, Georgia 31721 Map It | 106 WAX MYRTLE DR ALBANY, Georgia 31721 Map It | The following materials are required to complete your application:
| MURCHLAND1.pdf | |||||||||||||||||||||||
| 2024-68761253 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 04/14/2025 | 04/14/2025 | TY BROWN | Replacement or New Appliance | 1 | $200.00 | 200 | New Installation | Tankless Water Heater ($200.00) | RINNAI | RL75EP | PC.CA-043165 | 04/14/2025 | GREENHILL-CONSTRUCTION.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | GREENHILL CONSTRUCTION | (229) 869-3006 | 629 PEEL ROAD EDISON, Georgia 39846 Map It | 629 PEEL ROAD EDISON, Georgia 39846 Map It | The following materials are required to complete your application:
| GREENHILL-CONSTRUCTION1.pdf | |||||||||||||||||||||||
| 2024-97879618 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 04/10/2025 | 04/10/2025 | MIKE BURLESON | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Tankless Water Heater ($200.00) | RINNAI | RX199IN/P | SL.BA-199107 | 04/10/2025 | SALTER.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | JUDGE JOHN SALTER | (229) 347-0426 | 4948 MILLSBEE CIRCLE ALBANY, Georgia 31721 Map It | 4948 MILLSBEE CIRCLE ALBANY, Georgia 31721 Map It | The following materials are required to complete your application:
| SALTER1.pdf | |||||||||||||||||||||||
| 2024-12377181 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 04/12/2025 | 04/12/2025 | MIKE BURLESON | Replacement or New Appliance | 1 | $200.00 | 200 | New Installation | Tankless Water Heater ($200.00) | RINNAI | RE180EP | RJ.UA-125140 | 04/12/2025 | lamon.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | LAMON COMPANY | (229) 288-4276 | 116 CREEKSIDE DRIVE LEESBURG, Georgia 31763 Map It | 116 CREEKSIDE DRIVE LEESBURG, Georgia 31763 Map It | The following materials are required to complete your application:
| lamon1.pdf | |||||||||||||||||||||||
| Invoice # | Company Name | Company Contact | Company Phone | Company Email | Rebate Status | Safety Inspection Date | Purchase/Invoice Date | Safety Inspector’s Full Name | Type of Installation | How many rebates would you like to claim? | Total | Total | Installation Type | Appliance Type | Brand | Model # | Model # | Serial Number | Installation Date | Upload Receipt | Appliance Type | Brand | Model # | Model # | Serial Number | Installation Date | Upload Receipt | Appliance Type | Brand | Model # | Model # | Serial Number | Installation Date | Upload Receipt | Propane Company Name | Propane Marketer Name | Mailing Address | Email Address | Phone Number | Customer / Recipient Name | Customer / Recipient Phone Number | Customer / Recipient Email | Customer / Recipient Address | Customer / Recipient Installation Address | Required Materials | Upload Proof of Purchase: | Name of Builder/Contractor | Upload Spec Sheet for Manufactured Home |
