Manage Appliance Rebates (CSV ONLY) – 2024

Invoice #Company NameCompany ContactCompany PhoneCompany EmailRebate StatusSafety Inspection DatePurchase/Invoice DateSafety Inspector’s Full NameType of InstallationWere you affected by hurricane Helene?What county do you live in?How many rebates would you like to claim?Installation TypeRebate #1Appliance TypeAppliance TypeBrandModel #Serial NumberInstallation DateUpload ReceiptRebate #2Appliance TypeAppliance TypeBrandModel #Serial NumberInstallation DateUpload ReceiptRebate #3Appliance TypeAppliance TypeBrandModel #Serial NumberInstallation DateUpload ReceiptTotal Exceeds $500TotalTotalPropane Company NamePropane Marketer NameMailing AddressEmail AddressPhone NumberCustomer / Recipient NameCustomer / Recipient Phone NumberCustomer / Recipient EmailNo Customer EmailCustomer / Recipient AddressCustomer / Recipient Installation AddressUpload Supporting DocumentsRequired MaterialsUpload Proof of Purchase:Name of Builder/ContractorUpload Spec Sheet for Manufactured Home
2024-20517898Conger LP gas MoultrieKyle Johnson(229) 985-6942Email hidden; Javascript is required.Processing04/29/202504/29/2025Dewayne BruceReplacement or New ApplianceYesAppling1Replacement InstallationTankless Water Heater ($400.00)RinnaiRL75EPPC.CA-03994204/29/20251810_250507122013_001.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$400.00400Conger LP Gas MoultrieKyle Johnson3117 veterans parkway s
Moultrie, Georgia 31768
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Email hidden; Javascript is required.(229) 985-6942Gilbert Jimenez(229) 798-0572Email hidden; Javascript is required.511 Overlook dr
Moultrie, Georgia 31768
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511 Overlook dr
Moultrie, Georgia 31768
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
1810_250507122013_0011.pdf
2024-69274226Modern Gas Company, Inc.Mark Holloway(229) 435-6116Email hidden; Javascript is required.Processing05/02/202505/02/2025RICKY HUIRASReplacement or New ApplianceNo1New InstallationTankless Water Heater ($200.00)RINNAIRX199IN/PSM.BA-22308005/02/2025WALLS.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$200.00200MODERN GAS COMPANYMARK HOLLOWAY1335 US HWY 82 EST
LEESBURG, Georgia 31763
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Email hidden; Javascript is required.(229) 435-6116DAVD & MICHELLE WALLS(229) 322-9293
  • I do not have a customer email
618 SCENIC ROUTE
CORDELE, Georgia 31015
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618 SCENIC ROUTE
CORDELE, Georgia 31015
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
WALLS1.pdf
2024-17078353Modern Gas Company, Inc.Mark Holloway(229) 435-6116Email hidden; Javascript is required.Processing05/05/202505/05/2025MIKE BURLESONNew ConstructionNo1Tankless Water Heater ($200.00)RINNAIRE180EPSF.UA-08543405/05/2025SHAW-881856.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$200.00200MODERN GAS COMPANYMARK HOLLOWAY1335 US HWY 82 EST
LEESBURG, Georgia 31763
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Email hidden; Javascript is required.(229) 435-6116SHAW MERRITT CONSTRUCTION(229) 291-8510
  • I do not have a customer email
161 COVE RD
LEESBURG, Georgia 31763
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161 COVE RD
LEESBURG, Georgia 31763
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
SHAW MERRITT CONSTRUCTION
2024-13965348Modern Gas Company, Inc.Mark Holloway(229) 435-6116Email hidden; Javascript is required.Processing05/05/202505/05/2025MIKE BURLESONNew ConstructionNo1Tankless Water Heater ($200.00)RINNAIRE180EPSF.UA-08543305/05/2025SHAW-881848.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$200.00200MODERN GAS COMPANYMARK HOLLOWAY1335 US HWY 82 EST
LEESBURG, Georgia 31763
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Email hidden; Javascript is required.(229) 435-6116SHAW MERRITT CONSTRUCTION(229) 291-8510
  • I do not have a customer email
120 COVE ROAD
LEESBURG, Georgia 31763
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120 COVE ROAD
LEESBURG, Georgia 31763
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
SHAW MERRITT CONSTRUCTION
2024-14543987Modern Gas Company, Inc.Mark Holloway(229) 435-6116Email hidden; Javascript is required.Processing05/05/202505/05/2025MIKE BURLESONNew ConstructionNo1Tankless Water Heater ($200.00)RINNAIRE180EPSF.UA-08233505/05/2025SHAW-881851.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$200.00200MODERN GAS COMPANYMARK HOLLOWAY1335 US HWY 82 EST
LEESBURG, Georgia 31763
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Email hidden; Javascript is required.(229) 435-6116SHAW MERRITT CONSTRUCTION(229) 291-8510
  • I do not have a customer email
154 COVE RD
LEESBURG, Georgia 31763
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154 COVE RD
LEESBURG, Georgia 31763
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
SHAW MERRITT CONSTRUCTION
2024-16519385Modern Gas Company, Inc.Mark Holloway(229) 435-6116Email hidden; Javascript is required.Processing05/05/202505/05/2025MIKE BURLESONNew ConstructionNo1Tankless Water Heater ($200.00)RINNAIRE180EPRJ.UA-12514505/05/2025SHAW-881853.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$200.00200MODERN GAS COMPANYMARK HOLLOWAY1335 US HWY 82 EST
LEESBURG, Georgia 31763
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Email hidden; Javascript is required.(229) 435-6116SHAW MERRITT CONSTRUCTION(229) 291-8510
  • I do not have a customer email
172 COVE RD
LEESBURG, Georgia 31763
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172 COVE RD
LEESBURG, Georgia 31763
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
SHAW MERRITT CONSTRUCTION
2024-91650415Modern Gas Company, Inc.Mark Holloway(229) 435-6116Email hidden; Javascript is required.Processing05/01/202505/01/2025MIKE BURLESONReplacement or New ApplianceNo1Replacement InstallationTankless Water Heater ($200.00)RINNAIRL75EPPC.CA-04316705/01/2025WALKER.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$200.00200MODERN GAS COMPANYMARK HOLLOWAY1335 US HWY 82 EST
LEESBURG, Georgia 31763
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Email hidden; Javascript is required.(229) 435-6116JOE WALKER(229) 777-7884
  • I do not have a customer email
408 SHINGLER LITTLE RIVER RD
SUMNER, Georgia 31789
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408 SHINGLER LITTLE RIVER RD
SUMNER, Georgia 31789
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
WALKER1.pdf
2024-13580177Modern Gas Company, Inc.Mark Holloway(229) 435-6116Email hidden; Javascript is required.Processing05/02/202505/02/2025MIKE BURLESONReplacement or New ApplianceNo1Replacement InstallationTankless Water Heater ($200.00)RINNAIRX160INSL.BA-19568205/02/2025HIGHTOWER.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$200.00200MODERN GAS COMPANYMARK HOLLOWAY1335 US HWY 82 EST
LEESBURG, Georgia 31763
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Email hidden; Javascript is required.(229) 435-6116MORRIS FAIRCLOTH(229) 328-8036
  • I do not have a customer email
133 FOWLER DR
LEESBURG, Georgia 31763
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133 FOWLER DR
LEESBURG, Georgia 31763
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
FAIRCLOTH.pdf
2024-12384487Modern Gas Company, Inc.Mark Holloway(229) 435-6116Email hidden; Javascript is required.Processing05/01/202505/01/2025CURTIS HUNTERReplacement or New ApplianceNo1New InstallationTankless Water Heater ($200.00)RINNAIRE199EPSH.UA-11774705/01/2025WARRENN.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$200.00200MODERN GAS COMPANYMARK HOLLOWAY1335 US HWY 82 EST
LEESBURG, Georgia 31763
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Email hidden; Javascript is required.(229) 435-6116THOMAS & JENNY WARREN(229) 938-2268
  • I do not have a customer email
260 DANVILLE RD
AMERICUS, Georgia 31709
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260 DANVILLE RD
AMERICUS, Georgia 31709
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
WARRENN1.pdf
2024-15003362Modern Gas Company, Inc.Mark Holloway(229) 435-6116Email hidden; Javascript is required.Processing05/06/202505/06/2025ROYCE HUNTERReplacement or New ApplianceNo1New InstallationTankless Water Heater ($200.00)RINNAIRX180IN/PSK.BA-16954805/06/2025NEALEY.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$200.00200MODERN GAS COMPANYMARK HOLLOWAY1335 US HWY 82 EST
LEESBURG, Georgia 31763
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Email hidden; Javascript is required.(229) 435-6116WENDELL NEALEY(229) 894-9680
  • I do not have a customer email
969 THRASHER RD
PLAINS, Georgia 31780
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969 THRASHER RD
PLAINS, Georgia 31780
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
NEALEY1.pdf
2024-13233125Modern Gas Company, Inc.Mark Holloway(229) 435-6116Email hidden; Javascript is required.Processing05/05/202505/05/2025RICKY HUIRASNew ConstructionNo1Tankless Water Heater ($200.00)RINNAIRL94IPPC.CA-04882805/05/2025DOUBLEGATE-HOMES.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$200.00200MODERN GAS COMPANYMARK HOLLOWAY1335 US HWY 82 EST
LEESBURG, Georgia 31763
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Email hidden; Javascript is required.(229) 435-6116DOUBLEGATE HOMES(229) 376-2624
  • I do not have a customer email
193 THISTLEDOWN DR
LEESBURG, Georgia 31763
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193 THISTLEDOWN DR
LEESBURG, Georgia 31763
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
DOUBLEGATE HOMES
2024-11416898Modern Gas Company, Inc.Mark Holloway(229) 435-6116Email hidden; Javascript is required.Processing05/01/202505/01/2025MIKE BURLESONReplacement or New ApplianceNo1Replacement InstallationStorage-Type Water Heater ($200.00)BRADFORD WHITERG250T6XAL5436509105/01/2025HIGHTOWER1.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$200.00200MODERN GAS COMPANYMARK HOLLOWAY1335 US HWY 82 EST
LEESBURG, Georgia 31763
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Email hidden; Javascript is required.(229) 435-6116WILLIE HIGHTOWER(229) 886-0815
  • I do not have a customer email
256 HAWKSTEAD DR
LEESBURG, Georgia 31763
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256 HAWKSTEAD DR
LEESBURG, Georgia 31763
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
HIGHTOWER2.pdf
2024-12160133Conger LP GasKAYLEA SMITH(229) 469-4250Email hidden; Javascript is required.Processing04/11/202503/11/2025Donald AlfordReplacement or New ApplianceYesLowndes1Replacement InstallationTankless Water Heater ($400.00)rinnairep160eppk.ua-11344403/11/20252154_250507144959_001.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$400.00400Conger Lp gasMonty Hall2310 -B Hwy 84 West
2310- B hwy 84 west
Valdosta, Georgia 31601
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Email hidden; Javascript is required.(229) 469-4250Premier southern(229) 263-1602Email hidden; Javascript is required.5985 mcmillian
hahira, Georgia 31632
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5985 mcmillian
hahira, Georgia 31632
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
2154_250507144959_0011.pdf
2024-22051423Modern Gas Company, Inc.Mark Holloway(229) 435-6116Email hidden; Javascript is required.Processing05/02/202505/02/2025CURTIS HUNTERNew ConstructionNo2Tankless Water Heater ($200.00)RINNAIRXP199IN/PSE.BA-08016405/02/2025WELTON.pdfTankless Water Heater ($200.00)RINNAIRXP199IN/PSE.BA-07913205/02/2025WELTON1.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$400.00400MODERN GAS COMPANYMARK HOLLOWAY1335 US HWY 82 EST
LEESBURG, Georgia 31763
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Email hidden; Javascript is required.(229) 435-6116JC WELTON CONSTRUCTION(772) 388-8882
  • I do not have a customer email
5645 VENEYS MILL POND RD
PARROTT, Georgia 39877
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5645 VENEYS MILL POND RD
PARROTT, Georgia 39877
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
JC WELTON CONSTRUCTION
2024-14880679Conger LP GasKAYLEA SMITH(229) 469-4250Email hidden; Javascript is required.Processing05/07/202504/11/2025Donald AlfordReplacement or New ApplianceYesLowndes1Replacement InstallationTankless Water Heater ($400.00)rinnaiREP160eppk.ua-11344704/11/20252154_250507144959_0012.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$400.00400Conger Lp gasMonty Hall2310 -B Hwy 84 West
2310- B hwy 84 west
Valdosta, Georgia 31601
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Email hidden; Javascript is required.(229) 469-4250Premier southern(229) 263-1602Email hidden; Javascript is required.5985 mcmillian
hahira, Georgia 31632
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5985 mcmillian
hahira, Georgia 31632
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
2154_250507144959_0013.pdf
2024-18599584Modern Gas Company, Inc.Mark Holloway(229) 435-6116Email hidden; Javascript is required.Processing05/01/202505/01/2025ROYCE HUNTERReplacement or New ApplianceNo1New InstallationTankless Water Heater ($200.00)RINNAIRL75EPPC.CA-04314505/01/2025HOLCOMBE.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$200.00200MODERN GAS COMPANYMARK HOLLOWAY1335 US HWY 82 EST
LEESBURG, Georgia 31763
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Email hidden; Javascript is required.(229) 435-6116LANDON & FAITH HOLCOMBE(229) 854-3462
  • I do not have a customer email
142 QUAIL CHASE DR
LEESBURG, Georgia 31763
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142 QUAIL CHASE DR
LEESBURG, Georgia 31763
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
HOLCOMBE1.pdf
2024-10282290Conger LP GasLee Phillips(229) 386-5574Email hidden; Javascript is required.Processing04/17/202504/17/2025Taylor NewsomeReplacement or New ApplianceYesTift2New InstallationTankless Water Heater ($400.00)RinnaiRE199ePRH.UA-11440004/17/20252965_001.pdfTankless Water Heater ($400.00)RinnaiRL75ePPC.CA-04302704/17/20252965_0011.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$800.00800Conger LP GasLee MathewsPO Box 7644
Tifton, Georgia 31793
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Email hidden; Javascript is required.(229) 386-5574DKR Farms(229) 247-0200Email hidden; Javascript is required.25 Adams Rd.
Chula, Georgia 31733
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25 Adams Rd.
Chula, Georgia 31733
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
2965_0012.pdf
2024-15382681BATES GAS COMPANYCHRSITINE FOWLER(229) 436-5338Email hidden; Javascript is required.Processing05/08/202505/08/2025FLOYD BRANCHReplacement or New ApplianceNo1Replacement InstallationTankless Water Heater ($200.00)RINNAIRE160IPSL.UA-16713005/08/2025CLASSONREBATE.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$200.00200BATES GAS COMPANYCHRSITINE FOWLER2703 SYLVESTER RD
ALBANY, Georgia 31705
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Email hidden; Javascript is required.(229) 436-5338TRACY CLASSON(229) 886-1495
  • I do not have a customer email
136 UNCLE JIMMYS LANE
LEESBURG, Georgia 31763
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136 UNCLE JIMMYS LANE
LEESBURG, Georgia 31763
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
CLASSONREBATE1.pdf
2024-31876450Webb Brothers Propane, IncKristy Gamble(229) 382-0789Email hidden; Javascript is required.Processing05/09/202505/09/2025ROBERT COTHRENNew ConstructionNo1Tankless Water Heater ($200.00)RINNAIV53DEPRA-CA.0073505/09/2025JOSH-ROUSEY.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$200.00200Webb Brothers Propane, IncKristy GamblePO Drawer 7269
3615 Hwy 82 W
Tifton, Georgia 31793
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Email hidden; Javascript is required.(229) 382-0789JOSH ROUSEY(229) 392-0245
  • I do not have a customer email
235 WESLEY RIGDON RD
TIFTON, Georgia 31794
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235 WESLEY RIGDON RD
TIFTON, Georgia 31794
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
JOSH ROUSEY
2024-10913270Conger LP GasKAYLEA SMITH(229) 469-4250Email hidden; Javascript is required.Processing05/09/202504/14/2025Seth WeeksReplacement or New ApplianceYesLowndes1Replacement InstallationTankless Water Heater ($400.00)rinnaiREP160eppk.ua-11344204/14/20252179_250512074604_001.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$400.00400Conger Lp gasMonty Hall2310 -B Hwy 84 West
2310- B hwy 84 west
Valdosta, Georgia 31601
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Email hidden; Javascript is required.(229) 469-4250makayla mcghee(229) 412-8445
  • I do not have a customer email
169 lee's place
lake park, Georgia 31636
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169 lee's place
lake park, Georgia 31636
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
2179_250512074604_0011.pdf
2024-59218011Conger LP GasKAYLEA SMITH(229) 469-4250Email hidden; Javascript is required.Processing05/05/202503/27/2025Cole TruettReplacement or New ApplianceYesLowndes1Replacement InstallationTankless Water Heater ($400.00)rinnairx199isc.ba-04223003/27/20252181_250512081602_001.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$400.00400Conger Lp gasMonty Hall2310 -B Hwy 84 West
2310- B hwy 84 west
Valdosta, Georgia 31601
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Email hidden; Javascript is required.(229) 469-4250firm foundation(229) 561-0082Email hidden; Javascript is required.3795 bearlake rd
valdosta, Georgia 31601
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3795 bearlake rd
valdosta, Georgia 31601
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
2181_250512081602_0011.pdf
2024-51785549Conger LP GasKAYLEA SMITH(229) 469-4250Email hidden; Javascript is required.Processing05/05/202503/27/2025Cole TruettReplacement or New ApplianceYesLowndes1Replacement InstallationTankless Water Heater ($400.00)rinnairx199isc.ba-03890805/05/20252181_250512081602_0012.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$400.00400Conger Lp gasMonty Hall2310 -B Hwy 84 West
2310- B hwy 84 west
Valdosta, Georgia 31601
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Email hidden; Javascript is required.(229) 469-4250firm foundation(229) 561-0082Email hidden; Javascript is required.3795 bearlake rd
valdosta, Georgia 31601
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3795 bearlake rd
valdosta, Georgia 31601
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
2181_250512081602_0013.pdf
2024-15572484PARTNERS PROPANE OF GA INC.AMANDA ALBRITTON(478) 862-4644Email hidden; Javascript is required.Processing05/06/202505/06/2025Cody RUSTINReplacement or New ApplianceNo1Replacement InstallationStorage-Type Water Heater ($200.00)RheemProg40Q1125233405/06/2025wilann_0001.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$200.00200Partners Propane of Gaamanda AlbrittonPO BOX 277
BUTLER, Georgia 31006
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Email hidden; Javascript is required.(478) 862-4644Annette Williamson(478) 244-1556
  • I do not have a customer email
222 MLK Ave
Ideal, Georgia 31041
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222 MLK Ave
Ideal, Georgia 31041
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
2024-48879249Conger LP GasLee Phillips(229) 386-5574Email hidden; Javascript is required.Processing04/29/202504/29/2025Eric PritchardReplacement or New ApplianceYesTift1Replacement InstallationTankless Water Heater ($400.00)RinnaiRE180ePTB.UA-02264604/29/20253009_001.pdf

The maximum allowed per household is $500, please remove a rebate to continue.

$400.00400Conger LP GasLee Mathewspo
Tifton, Georgia 31793
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Email hidden; Javascript is required.(229) 386-5574David Conway(229) 402-2211Email hidden; Javascript is required.272 Gibbs Lane
Enigma, Georgia 31749
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272 Gibbs Lane
Enigma, Georgia 31749
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
3009_0011.pdf
2024-58592088Conger LP GasLee Phillips(229) 386-5574Email hidden; Javascript is required.Processing05/05/202505/05/2025Eric PritchardReplacement or New ApplianceYesTift1Replacement InstallationTankless Water Heater ($400.00)RinnaiRL75ePPC.CA-04521505/05/2025

The maximum allowed per household is $500, please remove a rebate to continue.

$400.00400Conger LP GasLee MathewsPO Box 7644
Tifton, Georgia 31793
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Email hidden; Javascript is required.(229) 386-5574Whipple Jack Farms(229) 821-1081Email hidden; Javascript is required.407 Red Oak Rd.
Tifton, Georgia 31794
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407 Red Oak Rd.
Tifton, Georgia 31794
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The following materials are required to complete your application:
  • Proof of purchase (copy of end user’s sales receipt or invoice for the propane appliances)
3010_0012.pdf
Invoice #Company NameCompany ContactCompany PhoneCompany EmailRebate StatusSafety Inspection DatePurchase/Invoice DateSafety Inspector’s Full NameType of InstallationWere you affected by hurricane Helene?What county do you live in?How many rebates would you like to claim?Installation TypeRebate #1Appliance TypeAppliance TypeBrandModel #Serial NumberInstallation DateUpload ReceiptRebate #2Appliance TypeAppliance TypeBrandModel #Serial NumberInstallation DateUpload ReceiptRebate #3Appliance TypeAppliance TypeBrandModel #Serial NumberInstallation DateUpload ReceiptTotal Exceeds $500TotalTotalPropane Company NamePropane Marketer NameMailing AddressEmail AddressPhone NumberCustomer / Recipient NameCustomer / Recipient Phone NumberCustomer / Recipient EmailNo Customer EmailCustomer / Recipient AddressCustomer / Recipient Installation AddressUpload Supporting DocumentsRequired MaterialsUpload Proof of Purchase:Name of Builder/ContractorUpload Spec Sheet for Manufactured Home