| 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 | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2024-10436149 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 07/24/2025 | 07/24/2025 | Donald Alford | Replacement or New Appliance | 1 | $400.00 | 400 | Replacement Installation | Rinnai | RE160eP | SJ.UA-142457 | 07/24/2025 | OWENS-209_3004_250728120559_001.pdf | Conger LP Gas | Richard McCranie | 2310 US HWY 84 W Suite B 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 | 209 Bailey Circle Thomasville, Georgia 31792 Map It | The following materials are required to complete your application:
| OWENS-209_3004_250728120559_0011.pdf | |||||||||||||||||||||||
| 2024-27957859 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 07/01/2025 | 07/01/2025 | Cole Truett | Replacement or New Appliance | 1 | $800.00 | 800 | Replacement Installation | Rinnai | PK.UA-113449 | 07/01/2025 | MCCRANIE_3007_250728124822_001.pdf | Conger LP Gas | Richard McCranie | 2310 US HWY 84 W Suite B Valdosta, Georgia 31601 Map It | Email hidden; Javascript is required. | (229) 469-4250 | Richard McCranie | (229) 507-3994 | Email hidden; Javascript is required. | 2576 Cross Creek Road Nashville, Georgia 31639 Map It | 2576 Cross Creek Road Nashville, Georgia 31639 Map It | The following materials are required to complete your application:
| MCCRANIE_3007_250728124822_0011.pdf | ||||||||||||||||||||||||
| 2024-18364270 | Conger LP Gas | Lee Phillips | (229) 386-5574 | Email hidden; Javascript is required. | Processing | 06/30/2025 | 06/30/2025 | Eric Pritchard | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | REP160eP | PL.UA-119983 | 06/30/2025 | 3918_001.pdf | Conger LP Gas | Lee Mathews | PO Box 7644 Tifton, Georgia 31793 Map It | Email hidden; Javascript is required. | (229) 386-5574 | CNK Properties | (229) 386-0440 | Email hidden; Javascript is required. | PO Box 7711 Tifton, Georgia 31793 Map It | 113 Branch Street Tifton, Georgia 31793 Map It | The following materials are required to complete your application:
| 3918_0011.pdf | ||||||||||||||||||||||
| 2024-44172103 | Conger LP Gas | Lee Phillips | (229) 386-5574 | Email hidden; Javascript is required. | Processing | 07/09/2025 | 07/09/2025 | Eric Pritchard | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180eP | TB.UA-022654 | 07/09/2025 | 3926_001.pdf | Conger LP Gas | Lee Mathews | PO Box 7644 Tifton, Georgia 31793 Map It | Email hidden; Javascript is required. | (229) 386-5574 | Jessica Murillo | (229) 392-4602 | Email hidden; Javascript is required. | 1628 Elton Clark Rd. Omega, Georgia 31775 Map It | 1628 Elton Clark Rd. Omega, Georgia 31775 Map It | The following materials are required to complete your application:
| 3926_0011.pdf | ||||||||||||||||||||||
| 2024-93852537 | Sikes Propane Inc | Daniel Sikes Jr | (912) 367-1151 | Email hidden; Javascript is required. | Processing | 07/18/2025 | 07/18/2025 | DANIEL SIKES | Replacement or New Appliance | 1 | $200.00 | 200 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180e | SE.UA-059929 | 07/18/2025 | HPSCAN_20250728152920896_2025-07-28_153008570-compressed.pdf | SIKES PROPANE INC. | SIKES PROPANE | 2174 HATCH PARKWAY SOUTH BAXLEY, Georgia 31513 Map It | Email hidden; Javascript is required. | (912) 367-1151 | DOWN 2 EARTH TRAILERS | (912) 367-3007 | P.O BOX 509 BAXLEY, Georgia 31515 Map It | 1605 EAST PARKER ST BAXLEY, Georgia 31513 Map It | The following materials are required to complete your application:
| HPSCAN_20250728152920896_2025-07-28_153008570-compressed1.pdf | |||||||||||||||||||||||
| 2024-78205484 | Conger LP Gas | Lee Phillips | (229) 386-5574 | Email hidden; Javascript is required. | Processing | 06/30/2025 | 06/30/2025 | Hunter Seabolt | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | REP160eP | PL.UA-119971 | 06/30/2025 | 3928_001.pdf | Conger LP Gas | Lee Mathews | PO Box 7644 Tifton, Georgia 31793 Map It | Email hidden; Javascript is required. | (229) 386-5574 | Mark Troyer | (229) 326-8444 | Email hidden; Javascript is required. | 296 Hazelnut Rd. Ocilla, Georgia 31774 Map It | 296 Hazelnut Rd. Ocilla, Georgia 31774 Map It | The following materials are required to complete your application:
| 3928_0011.pdf | ||||||||||||||||||||||
| 2024-18026952 | Conger LP Gas | Lee Phillips | (229) 386-5574 | Email hidden; Javascript is required. | Processing | 07/11/2025 | 07/11/2025 | Taylor Newsome | Replacement or New Appliance | 1 | $800.00 | 800 | Replacement Installation | Rinnai | PL.UA-119961 | 07/11/2025 | 3930_001.pdf | Conger LP Gas | Lee Mathews | PO Box 7644 Tifton, Georgia 31793 Map It | Email hidden; Javascript is required. | (229) 386-5574 | Kenny Boyer | (229) 646-2942 | Email hidden; Javascript is required. | 300 Tifton Investment Lane Alapaha, Georgia 31794 Map It | 300 Tifton Investment Lane Alapaha, Georgia 31794 Map It | The following materials are required to complete your application:
| 3930_0011.pdf | ||||||||||||||||||||||||
| 2024-11414129 | Sikes Propane Inc | Daniel Sikes Jr | (912) 367-1151 | Email hidden; Javascript is required. | Processing | 07/29/2025 | 07/29/2025 | DANIEL SIKES | New Construction | 2 | $800.00 | 800 | RINNAI | RE199e | RC.UA-047785 | 07/29/2025 | HPSCAN_20250729185737081_2025-07-29_185824712-compressed.pdf | RINNAI | RE180 | RE.UA-062575 | 07/29/2025 | HPSCAN_20250729185737081_2025-07-29_185824712-compressed1.pdf | SIKES PROPANE INC. | SIKES PROPANE | 2174 HATCH PARKWAY SOUTH BAXLEY, Georgia 31513 Map It | Email hidden; Javascript is required. | (912) 367-1151 | KEN HEATON | (703) 232-6314 | P.O. BOX 396 ALMA, Georgia 31510 Map It | P.O. BOX 396 ALMA, Georgia 31510 Map It | The following materials are required to complete your application:
| EDDIE LUGO CONSTRUCTION | ||||||||||||||||||||
| 2024-12665340 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Processing | 07/23/2025 | 07/23/2025 | RICKY JARRELL | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | GE | GP50T08BXR01 | GV60145BC | 07/23/2025 | HAMPSON.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | SUSAN HAMPSON | (229) 347-3274 | 152 AMBLESIDE DR LEESBURG, Georgia 31763 Map It | 152 AMBLESIDE DR LEESBURG, Georgia 31763 Map It | The following materials are required to complete your application:
| HAMPSON1.pdf | |||||||||||||||||||||||
| 2024-19384254 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Processing | 07/09/2025 | 07/09/2025 | RICKY HUIRAS | New Construction | 1 | $200.00 | 200 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180IP | TA.VA-000941 | 07/09/2025 | purvis.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | C PURVIS CONSTRUCTION | (229) 308-9204 | 463 ED STEPHNES RD COBB, Georgia 31735 Map It | 463 ED STEPHNES RD COBB, Georgia 31735 Map It | The following materials are required to complete your application:
| C PURVIS CONSTRUCTION | ||||||||||||||||||||||||
| 2024-31139821 | BATES GAS COMPANY | CHRSITINE FOWLER | (229) 436-5338 | Email hidden; Javascript is required. | Processing | 07/30/2025 | 07/30/2025 | WILLIAM BATES | New Construction | 1 | $200.00 | 200 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE160EP | TD.UA-047418 | 07/30/2025 | STATION7RINNAI.pdf | BATES GAS COMPANY | CHRSITINE FOWLER | 2703 SYLVESTER RD ALBANY, Georgia 31705 Map It | Email hidden; Javascript is required. | (229) 436-5338 | STATION 7 BBQ | (229) 886-1854 | 1600 E. OGLETHORPE BLVD ALBANY, Georgia 31705 Map It | 1600 E. OGLETHORPE BLVD ALBANY, Georgia 31705 Map It | The following materials are required to complete your application:
| MITCH NOLAN | ||||||||||||||||||||||||
| 2024-19484307 | BATES GAS COMPANY | CHRSITINE FOWLER | (229) 436-5338 | Email hidden; Javascript is required. | Processing | 07/29/2025 | 07/29/2025 | WILLIAM BATES | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180EP | SH.UA-116056 | 07/29/2025 | EDMONSONRINNAI.pdf | BATES GAS COMPANY | CHRSITINE FOWLER | 2703 SYLVESTER RD ALBANY, Georgia 31705 Map It | Email hidden; Javascript is required. | (229) 436-5338 | SEAN EDMONSON | (229) 886-5884 | 139 HARTSFIELD LEESBURG, Georgia 31763 Map It | 139 HARTSFIELD LEESBURG, Georgia 31763 Map It | The following materials are required to complete your application:
| EDMONSONRINNAI1.pdf | |||||||||||||||||||||||
| 2024-73052889 | Sikes Propane Inc | Daniel Sikes Jr | (912) 367-1151 | Email hidden; Javascript is required. | Processing | 07/08/2025 | 07/08/2025 | DANIEL SIKES | Replacement or New Appliance | 1 | $50.00 | 50 | Replacement Installation | Cooktop ($50.00) | THOR | HRT3618ULP | HRT3618ULP2402021 | 07/08/2025 | HPSCAN_20250730174943526_2025-07-30_175031150-compressed.pdf | SIKES PROPANE INC. | SIKES PROPANE | 2174 HATCH PARKWAY SOUTH BAXLEY, Georgia 31513 Map It | Email hidden; Javascript is required. | (912) 367-1151 | KEN HEATON | (703) 232-6314 | P.O. BOX 396 ALMA, Georgia 31510 Map It | P.O. BOX 396 ALMA, Georgia 31510 Map It | The following materials are required to complete your application:
| HPSCAN_20250730174943526_2025-07-30_175031150-compressed1.pdf | |||||||||||||||||||||||
| 2024-73861117 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 07/25/2025 | 07/25/2025 | Matthew Ray | Replacement or New Appliance | 2 | $800.00 | 800 | Replacement Installation | Rinnai | RE160eP | TC.UA-042456 | 07/25/2025 | BOONE_3037_250731101922_001.pdf | Rinnai | RE180eP | TB.UA-021750 | 07/25/2025 | BOONE_3037_250731101922_0011.pdf | Conger LP Gas | Richard McCranie | 2310 US HWY 84 W Valdosta, Georgia 31601 Map It | Email hidden; Javascript is required. | (229) 469-4250 | William Boone | (229) 232-6370 | Email hidden; Javascript is required. | 5947 Shevette Road Lake Park, Georgia 31636 Map It | 5947 Shevette Road Lake Park, Georgia 31636 Map It | The following materials are required to complete your application:
| BOONE_3037_250731101922_0012.pdf | ||||||||||||||||||
| 2024-98300100 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 08/02/2025 | 08/02/2025 | Donald Alford | Replacement or New Appliance | 1 | $400.00 | 400 | Replacement Installation | Rinnai | RX199iN | SM.BA-225752 | 08/02/2025 | POWELL_3066_250804145225_001.pdf | Conger LP Gas | Richard McCranie | 2310 US HWY 84 W Suite B Valdosta, Georgia 31601 Map It | Email hidden; Javascript is required. | (229) 561-9900 | Rita Powell | (229) 561-9900 | Email hidden; Javascript is required. | 5771 Lake Park Road Lake Park, Georgia 31636 Map It | 5771 Lake Park Road Lake Park, Georgia 31636 Map It | The following materials are required to complete your application:
| POWELL_3066_250804145225_0011.pdf | |||||||||||||||||||||||
| 2024-38203036 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 08/01/2025 | 08/01/2025 | Seth Weeks | Replacement or New Appliance | 1 | $400.00 | 400 | Replacement Installation | Rinnai | RE160eP | SF.UA-078416 | 08/01/2025 | classic_3067_250804145307_001.pdf | Conger LP Gas | Richard McCranie | 2310 US HWY 84 W Suite B Valdosta, Georgia 31601 Map It | Email hidden; Javascript is required. | (229) 469-4250 | Classic Homes By Weaver | (229) 563-5365 | Email hidden; Javascript is required. | 237 Northside Drive Valdosta, Georgia 31601 Map It | 3864 Lu Lane Hahira, Georgia 31636 Map It | The following materials are required to complete your application:
| classic_3067_250804145307_0011.pdf | |||||||||||||||||||||||
| 2024-10898985 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 07/13/2025 | 07/13/2025 | Cole Truett | Replacement or New Appliance | 2 | $800.00 | 800 | Replacement Installation | Rinnai | RX180iN | SH.BA-133687 | 07/13/2025 | BAILEY_3068_250804145350_001.pdf | Rinnai | RX180iN | SH.BA-133688 | 07/13/2025 | BAILEY_3068_250804145350_0011.pdf | Conger LP Gas | Richard McCranie | 2310 US HWY 84 W Suite B Valdosta, Georgia 31601 Map It | Email hidden; Javascript is required. | (229) 469-4250 | Franklin Bailey | (229) 251-4525 | Email hidden; Javascript is required. | 3940 Fawnview Valdosta, Georgia 31605 Map It | 3977 Trailwood Court Valdosta, Georgia 31601 Map It | The following materials are required to complete your application:
| BAILEY_3068_250804145350_0012.pdf | ||||||||||||||||||
| 2024-61349278 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 07/22/2025 | 07/22/2025 | Seth Weeks | Replacement or New Appliance | 2 | $800.00 | 800 | Replacement Installation | Rinnai | RE160eP | SD.UA-053502 | 07/22/2025 | BUILDING_3069_250804145435_001.pdf | Rinnai | RE160eP | TC.UA-042453 | 07/22/2025 | BUILDING_3069_250804145435_0011.pdf | Conger LP Gas | Richard McCranie | 2310 US HWY 84 W Suite B Valdosta, Georgia 31601 Map It | Email hidden; Javascript is required. | (229) 469-4250 | Building Valdosta | (229) 740-0978 | Email hidden; Javascript is required. | 231 Northside Drive Valdosta, Georgia 31602 Map It | 3008 Mary Powell Hahira, Georgia 31632 Map It | The following materials are required to complete your application:
| BUILDING_3069_250804145435_0012.pdf | ||||||||||||||||||
| 2024-12406724 | Conger LP | Debora Simning | (229) 776-7336 | Email hidden; Javascript is required. | Processing | 08/04/2025 | 08/04/2025 | Jamie Seabolt | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180e | TD.UA-058693 | 08/04/2025 | irvin_20250805_0002.pdf | Conger LP | Debora Simning | 306 S Main St Sylvester, Georgia 31791 Map It | Email hidden; Javascript is required. | (229) 776-7336 | Lynne Irvin | (229) 567-3002 | 255 Rusty Nail Rd Ashburn, Georgia 31714 Map It | 255 Rusty Nail Rd Ashburn, Georgia 31714 Map It | The following materials are required to complete your application:
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| 2024-12085726 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 08/05/2025 | 08/05/2025 | Matthew Ray | Replacement or New Appliance | 2 | $500.00 | 500 | Replacement Installation | Rinnai | RE180eP | TE.UA-065195 | 08/05/2025 | CULPEPPER_3095_250806090731_001.pdf | Forno | FFSGS6325-30 | 24090051 | 08/05/2025 | CULPEPPER_3095_250806090731_0011.pdf | Conger LP Gas | Richard McCranie | 2310 US HWY 84 W Suite B Valdosta, Georgia 31601 Map It | Email hidden; Javascript is required. | (229) 563-4282 | Brooks Culpepper | (229) 563-4282 | Email hidden; Javascript is required. | 197 Valentine Road Lake Park, Georgia 31636 Map It | 197 Valentine Road Lake Park, Georgia 31636 Map It | The following materials are required to complete your application:
| CULPEPPER_3095_250806090731_0012.pdf | ||||||||||||||||||
| 2024-16192556 | Conger LP gas Moultrie | Kyle Johnson | (229) 985-6942 | Email hidden; Javascript is required. | Processing | 07/24/2025 | 07/24/2025 | Jordan Ledford | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE160EP | TG.UA-095488 | 07/24/2025 | 2260_250806121817_001.pdf | Conger LP Gas Moultrie | Kyle Johnson | 3117 veterans parkway s Moultrie, Georgia 31768 Map It | Email hidden; Javascript is required. | (229) 985-6942 | Gilberto Jimenez | (229) 798-0572 | Email hidden; Javascript is required. | 511 Overlook dr Moultrie, Georgia 31788 Map It | 507 Overlook Dr Moultrie, Georgia 31788 Map It | The following materials are required to complete your application:
| 2260_250806121817_0011.pdf | ||||||||||||||||||||||
| 2024-25659140 | Conger LP GAS | christina Duncan | (912) 537-8722 | Email hidden; Javascript is required. | Incomplete | 07/24/2025 | 07/17/2025 | Jonathan Mauldin | Replacement or New Appliance | 1 | $400.00 | 400 | Replacement Installation | Rinnai | RE199ep | TD.UA-048639 | 07/17/2025 | joyner-2.pdf | Conger LP GAS | Christina Duncan | 604 North Broadfoot Blvd Vidalia, Georgia 30474 Map It | Email hidden; Javascript is required. | (912) 537-8722 | Jeremy Joyner | (912) 240-1272 | 430 Winge Rd Lyons, Georgia 30436 Map It | 430 Winge Rd Lyons, Georgia 30436 Map It | The following materials are required to complete your application:
| joyner-21.pdf | ||||||||||||||||||||||||
| 2024-98536792 | Conger LP | Debora Simning | (229) 776-7336 | Email hidden; Javascript is required. | Processing | 07/25/2025 | 07/25/2025 | justin seabolt | Replacement or New Appliance | 1 | $200.00 | 200 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180e | TD.UA-058697 | 07/25/2025 | irvin_0001.pdf | Conger LP | Debora Simning | 306 S Main St Sylvester, Georgia 31791 Map It | Email hidden; Javascript is required. | (229) 776-7336 | Ragan Paramore | (229) 881-5632 | Email hidden; Javascript is required. | 1753 Cane Mill Rd Doerun, Georgia 31744 Map It | 1753 Cane Mill Rd Doerun, Georgia 31744 Map It | The following materials are required to complete your application:
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| 2024-20625482 | Conger LP | Debora Simning | (229) 776-7336 | Email hidden; Javascript is required. | Processing | 08/04/2025 | 08/04/2025 | James Seabolt | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE199e | SK.UA-147881 | 08/04/2025 | fleming_0004.pdf | Conger LP | Debora Simning | 306 S Main St Sylvester, Georgia 31791 Map It | Email hidden; Javascript is required. | (229) 776-7336 | Carlton Fleming | (229) 386-0964 | 329 N Cedar Creek RD Cordele, Georgia 31015 Map It | 329 N Cedar Creek RD Cordele, Georgia 31015 Map It | The following materials are required to complete your application:
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| 2024-28717026 | PARTNERS PROPANE OF GA INC. | AMANDA ALBRITTON | (478) 862-4644 | Email hidden; Javascript is required. | Processing | 07/30/2025 | 07/30/2025 | Cody Rustin | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RHEEM | PROG50-36PRH60 | Q10254442 | 07/30/2025 | TY_0001.pdf | PARTNERS PROPANE OF GA | AMANDA ALBRITTON | PO BOX 277 BUTLER, Georgia 31006 Map It | Email hidden; Javascript is required. | (478) 862-4644 | TY HIRSCHBACH | (478) 847-9647 | 615 MACON RD REYNOLDS, Georgia 31076 Map It | 615 MACON RD REYNOLDS, Georgia 31076 Map It | The following materials are required to complete your application:
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| 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 |
