| 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 | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2025-35481073 | Hannah Saulnier | Processing | 08/05/2025 | 08/05/2025 | Matthew Ray | Replacement or New Appliance | 2 | $800.00 | 800 | Replacement Installation | Rinnai | RX199i | SM BA 214811 | 08/05/2025 | e5ddfb17-385e-4d4e-8f8f-24d3293415b33.pdf | Rinnai | RX199i | SM BA 225750 | 08/05/2025 | e5ddfb17-385e-4d4e-8f8f-24d3293415b34.pdf | Conger LP Gas | Richard McCranie | 2310B US Hwy 84 West Valdosta, Georgia 31601 Map It | Email hidden; Javascript is required. | (229) 469-4250 | Firm Foundation | (229) 561-0082 | Email hidden; Javascript is required. | 5101 Northwind Blvd Valdosta, Georgia 31605 Map It | 1023 Teresa Drive Lake Park, Georgia 31636 Map It | The following materials are required to complete your application:
| e5ddfb17-385e-4d4e-8f8f-24d3293415b35.pdf | |||||||||||||||||||||
| 2025-39072549 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Submitted | 08/15/2025 | 08/15/2025 | Cole Truett | Replacement or New Appliance | 1 | $400.00 | 400 | Replacement Installation | Rinnai | RE180eP | TB.UA-021745 | 08/15/2025 | GONZALES_3224_250819115009_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 | Joaquin Gonzales | (229) 237-0062 | Email hidden; Javascript is required. | 3812 Sirmans Lane Hahira, Georgia 31632 Map It | 2302 Dukes Ave Valdosta, Georgia 31602 Map It | The following materials are required to complete your application:
| GONZALES_3224_250819115009_0011.pdf | |||||||||||||||||||||||
| 2025-82778174 | Thompson Gas Company | Dot Waters | (912) 764-7383 | Email hidden; Javascript is required. | Submitted | 07/30/2025 | 07/30/2025 | Harry "Eddie" Taylor | New Construction | 1 | $200.00 | 200 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180e | RLUA145387 | 07/30/2025 | Rider.pdf | Thompson Gas | Dorothy Waters | 22801 Hwy 80 East Statesboro, Georgia 30461 Map It | Email hidden; Javascript is required. | (912) 764-7383 | Athur Rider | (706) 836-5783 | 5506 Hwy 56 South Waynesboro, Georgia 30830 Map It | 5506 Hwy 56 South Waynesboro, Georgia 30830 Map It | The following materials are required to complete your application:
| Thompson Gas | ||||||||||||||||||||||||
| 2025-94505290 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 08/19/2025 | 08/19/2025 | Matthew Ray | Replacement or New Appliance | 1 | $400.00 | 400 | Replacement Installation | Rinnai | RE160eP | SF.UA-078407 | 08/19/2025 | OWENS-311_3239_250820095108_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 | 311 Barry Field Circle Hahira, Georgia 31632 Map It | The following materials are required to complete your application:
| OWENS-311_3239_250820095108_0011.pdf | |||||||||||||||||||||||
| 2025-98967212 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 08/19/2025 | 08/19/2025 | Matthew Ray | Replacement or New Appliance | 1 | $400.00 | 400 | Replacement Installation | Rinnai | RE160eP | SF.UA-078406 | 08/19/2025 | OWENS-319_3240_250820095133_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 | 319 Barry Field Circle Hahira, Georgia 31632 Map It | The following materials are required to complete your application:
| OWENS-319_3240_250820095133_0011.pdf | |||||||||||||||||||||||
| 2025-79405749 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 08/19/2025 | 08/19/2025 | Matthew Ray | Replacement or New Appliance | 1 | $400.00 | 400 | Replacement Installation | Rinnai | RE160eP | SJ.UA-142456 | 08/19/2025 | OWENS-213_3241_250820095159_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 | 213 Barry Field Circle Hahira, Georgia 31632 Map It | The following materials are required to complete your application:
| OWENS-213_3241_250820095159_0011.pdf | |||||||||||||||||||||||
| 2025-49120878 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 08/19/2025 | 08/19/2025 | Matthew Ray | Replacement or New Appliance | 1 | $400.00 | 400 | Replacement Installation | Rinnai | RE160eP | SJ.UA-132523 | 08/19/2025 | OWENS-318_3242_250820095245_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 | 318 Barry Field Circle Hahira, Georgia 31632 Map It | The following materials are required to complete your application:
| OWENS-318_3242_250820095245_0011.pdf | |||||||||||||||||||||||
| 2025-28646228 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 08/19/2025 | 08/19/2025 | Matthew Ray | Replacement or New Appliance | 1 | $400.00 | 400 | Replacement Installation | Rinnai | RE160eP | TC.UA-042462 | 08/19/2025 | OWENS-315_3243_250820095317_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 | 315 Barry Field Circle Hahira, Georgia 31632 Map It | The following materials are required to complete your application:
| OWENS-315_3243_250820095317_0011.pdf | |||||||||||||||||||||||
| 2025-35941854 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 08/19/2025 | 08/19/2025 | Matthew Ray | Replacement or New Appliance | 1 | $400.00 | 400 | Replacement Installation | Rinnai | RE160eP | SJ.UA-142455 | 08/19/2025 | OWENS-307_3244_250820095346_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 | 307 Barry Field Circle Hahira, Georgia 31632 Map It | The following materials are required to complete your application:
| OWENS-307_3244_250820095346_0011.pdf | |||||||||||||||||||||||
| 2025-63898878 | BATES GAS COMPANY | CHRSITINE FOWLER | (229) 436-5338 | Email hidden; Javascript is required. | Submitted | 08/18/2025 | 08/18/2025 | FLOYD BRANCH | Replacement or New Appliance | 2 | $400.00 | 400 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | V53DEP | TE.CA-003602 | 08/18/2025 | BEAVERREBATE.pdf | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | V53DEP | TE.CA-003610 | 08/18/2025 | BEAVERREBATE1.pdf | BATES GAS COMPANY | CHRSITINE FOWLER | 2703 SYLVESTER RD ALBANY, Georgia 31705 Map It | Email hidden; Javascript is required. | (229) 436-5338 | DAVID BEAVER | (229) 669-2218 | 466 A LOVERS LANE RD LEESBURG, Georgia 31763 Map It | 466 A LOVERS LANE RD LEESBURG, Georgia 31763 Map It | The following materials are required to complete your application:
| BEAVERREBATE2.pdf | |||||||||||||||||
| 2025-12477875 | Blossman Gas | Rick Holsomback | (706) 638-2540 | Email hidden; Javascript is required. | Submitted | 07/23/2025 | 07/04/2025 | James Dennison | Replacement or New Appliance | 1 | $200.00 | 200 | Conversion | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RX160IN | SL.BA-190629 | 07/23/2025 | ROGERS-INVOICE.pdf | Blossman Gas | Rick Holsomback | 1725 N. Main Street LaFayette, Georgia 30728 Map It | Email hidden; Javascript is required. | (706) 638-2540 | Gregg Rogers | (423) 432-9040 | Email hidden; Javascript is required. | 312 Kailors Cove Circle Ringgold, Georgia 30736 Map It | 312 Kailors Cove Circle Ringgold, Georgia 30736 Map It | The following materials are required to complete your application:
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| 2025-58986796 | Sikes Propane Inc | Daniel Sikes Jr | (912) 367-1151 | Email hidden; Javascript is required. | Submitted | 08/06/2025 | 08/06/2025 | DANIEL SIKES | Replacement or New Appliance | 1 | $400.00 | 400 | Replacement Installation | RINNAI | RL75e | PC-CA-043133 | 08/06/2025 | HPSCAN_20250820203246969_2025-08-20_203335023-compressed.pdf | SIKES PROPANE INC. | SIKES PROPANE | 2174 HATCH PARKWAY SOUTH BAXLEY, Georgia 31513 Map It | Email hidden; Javascript is required. | (912) 367-1151 | HOYT ALTMAN | (912) 240-9817 | 495 CANNON RD BAXLEY, Georgia 31513 Map It | 495 CANNON RD BAXLEY, Georgia 31513 Map It | The following materials are required to complete your application:
| HPSCAN_20250820203246969_2025-08-20_203335023-compressed1.pdf | ||||||||||||||||||||||||
| 2025-62779203 | Webb Brothers Propane, Inc | Kristy Gamble | (229) 382-0789 | Email hidden; Javascript is required. | Submitted | 08/21/2025 | 08/21/2025 | MICHAEL WEBB | Replacement or New Appliance | 1 | $200.00 | 200 | Conversion | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180EP | SH.UA-116058 | 08/21/2025 | PATRICK-ATWATER.pdf | WEBB BROTHERS PROPANE | MICHAEL WEBB | PO Drawer 7269 TIFTON, Georgia 31793 Map It | Email hidden; Javascript is required. | (229) 382-0789 | PATRICK ATWATER | (229) 402-8800 | 2074 CHULA BROOKFIELD RD TIFTON, Georgia 31794 Map It | 2074 CHULA BROOKFIELD RD TIFTON, Georgia 31794 Map It | The following materials are required to complete your application:
| PATRICK-ATWATER1.pdf | |||||||||||||||||||||||
| 2025-69595608 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Submitted | 08/14/2025 | 08/14/2025 | Seth Weeks | Replacement or New Appliance | 1 | $800.00 | 800 | Replacement Installation | Rinnai | REP160eP | PG.UA-049593 | 08/14/2025 | CORBITT_3266_250822100521_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 | Corbett Construction | (229) 375-4124 | Email hidden; Javascript is required. | 178 William Road Lake Park, Georgia 31636 Map It | 254 Long Creek Road Lake Park, Georgia 31636 Map It | The following materials are required to complete your application:
| CORBITT_3266_250822100521_0011.pdf | |||||||||||||||||||||||
| 2025-44796734 | Franklin Propane Gas, Inc. | Mike Franklin | (478) 552-6667 | Email hidden; Javascript is required. | Submitted | 08/22/2025 | 08/22/2025 | Jonathan Franklin | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RL180EP | TB.UA-023502 | 08/22/2025 | Lambert-Rebate.pdf | Franklin Propane Gas | Mike Franklin | P O Box 5890 619 Sparta Road Sandersville, Georgia 31082 Map It | Email hidden; Javascript is required. | (478) 552-6667 | Grayson Lambert | (478) 357-4647 | Email hidden; Javascript is required. | 525 Transylvania Drive Sandersville, Georgia 31082 Map It | 525 Transylvania Drive Sandersville, Georgia 31082 Map It | The following materials are required to complete your application:
| Lambert-Rebate1.pdf | ||||||||||||||||||||||
| 2025-95095652 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Submitted | 08/13/2025 | 08/13/2025 | ROYCE HUNTER | Replacement or New Appliance | 1 | $400.00 | 400 | New Installation | Propane-Fueled Recirculating Water Heater ($400.00) | RINNAI | RXP199 | TC.BA-060035 | 08/13/2025 | PARKS.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | ROBERT & JENNIFER PARKS | (229) 942-5776 | 458 LAKESHORE WAY CORDELE, Georgia 31015 Map It | 458 LAKESHORE WAY CORDELE, Georgia 31015 Map It | The following materials are required to complete your application:
| PARKS1.pdf | |||||||||||||||||||||||
| 2025-54258924 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Submitted | 08/18/2025 | 08/18/2025 | RICKY JARRELL | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | GE | GP50T08BXRC01 | GV600195C | 08/18/2025 | COWLING.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | LYMAS COWLING | (757) 218-3980 | 156 SAPELO DR LEESBURG, Georgia 31763 Map It | 156 SAPELO DR LEESBURG, Georgia 31763 Map It | The following materials are required to complete your application:
| COWLING1.pdf | |||||||||||||||||||||||
| 2025-89679419 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Submitted | 08/20/2025 | 08/20/2025 | MIKE BURLESON | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180IP | TA.UA-00094 | 08/20/2025 | WOODRUFF.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | CHARLES WOODRUFF | (229) 894-3178 | 410 PLAINS HWY DAWSON, Georgia 39842 Map It | 410 PLAINS HWY DAWSON, Georgia 39842 Map It | The following materials are required to complete your application:
| WOODRUFF1.pdf | |||||||||||||||||||||||
| 2025-58992965 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Submitted | 08/20/2025 | 08/20/2025 | JOE & JUDY VANDEN BOSCH | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE199EP | TD.UA-054264 | 08/20/2025 | BOSCH.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | JOE & JUDY VANDEN BOSCH | (229) 886-8298 | 748 LAKESHORE DR CORDELE, Georgia 31015 Map It | 748 LAKESHORE DR CORDELE, Georgia 31015 Map It | The following materials are required to complete your application:
| BOSCH1.pdf | |||||||||||||||||||||||
| 2025-54577450 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Submitted | 08/12/2025 | 08/12/2025 | CURTIS HUNTER | New Construction | 1 | $200.00 | 200 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RL75IP | NL.CA-141567 | 08/12/2025 | BOGGUS.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | BILLY BOGGUS CONSTRUCTION | (229) 344-6529 | 119 STORNOWAY DR LEESBURG, Georgia 31763 Map It | 119 STORNOWAY DR LEESBURG, Georgia 31763 Map It | The following materials are required to complete your application:
| BILLY BOGGUS CONSTRUCTION | ||||||||||||||||||||||||
| 2025-47316529 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Submitted | 08/20/2025 | 08/20/2025 | RICKY JARRELL | Replacement or New Appliance | 1 | $200.00 | 200 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | GE | GP50T08BXR01 | GV601487C | 08/20/2025 | SOLOMON.pdf | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | CLEVE SOLOMON | (229) 395-4830 | 2206 OLD DOMINION DR ALBANY, Georgia 31721 Map It | 2206 OLD DOMINION DR ALBANY, Georgia 31721 Map It | The following materials are required to complete your application:
| SOLOMON1.pdf | |||||||||||||||||||||||
| 2025-39519054 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Submitted | 08/20/2025 | 08/20/2025 | Cole Truett | Replacement or New Appliance | 1 | $400.00 | 400 | Replacement Installation | Rinnai | RE180eP | TE.UA-065193 | 08/20/2025 | THORNTON_3275_250825122233_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 | Russell Thornton | (229) 561-0974 | Email hidden; Javascript is required. | 1074 West Hwy 122 Lakeland, Georgia 31635 Map It | 1074 West Hwy 122 Lakeland, Georgia 31635 Map It | The following materials are required to complete your application:
| THORNTON_3275_250825122233_0011.pdf | |||||||||||||||||||||||
| 2025-67058573 | Conger LP GAS | christina Duncan | (912) 537-8722 | Email hidden; Javascript is required. | Submitted | 08/21/2025 | 08/11/2025 | Jonathan Mauldin | New Construction | 1 | $400.00 | 400 | Rinnai | RX180IN | SL.BA-196779 | 08/11/2025 | myer.pdf | Conger LP GAS | Christina Duncan | 604 North Broadfoot Blvd Vidalia, Georgia 30474 Map It | Email hidden; Javascript is required. | (912) 537-8722 | Bodie Myer | (404) 947-3973 | 313 Wiggins Rd Lyons, Georgia 30436 Map It | 313 Wiggins Rd Lyons, Georgia 30436 Map It | The following materials are required to complete your application:
| Garrett Homes | |||||||||||||||||||||||||
| 2025-55738923 | Conger LP | Debora Simning | (229) 776-7336 | Email hidden; Javascript is required. | Submitted | 08/19/2025 | 08/19/2025 | James Seabolt | Replacement or New Appliance | 1 | $200.00 | 200 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RX160i | SK.BA-166295 | 08/19/2025 | goodwin_0001.pdf | Conger LP | Debora Simning | 306 S Main St Sylvester, Georgia 31791 Map It | Email hidden; Javascript is required. | (229) 776-7336 | Hunter Goodwin | (229) 206-4700 | Email hidden; Javascript is required. | 1304 Redrock Rd Sylvester, Georgia 31791 Map It | 1304 Redrock Rd Sylvester, Georgia 31791 Map It | The following materials are required to complete your application:
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| 2025-57152656 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Submitted | 08/22/2025 | 08/22/2025 | Alvin Wilcox | Replacement or New Appliance | 2 | $450.00 | 450 | Conversion | Cooktop ($50.00) | Samsung | NSGGDG85003RAA | 0LN07DAX80011F | 08/22/2025 | img08272025_0004.pdf | Propane furnace, or gas pack ($400.00) | Tempstar | NV | NV | 08/22/2025 | img08272025_00041.pdf | Folger Gas | Stacy Mullinax | 4955 Appalachian Hwy Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | Michael Hearne | (831) 809-8067 | Email hidden; Javascript is required. | 45104 Palemo Court King City, California 93930 Map It | 155 Paesano Rd Mineral Bluff, Georgia 30559 Map It | The following materials are required to complete your application:
| img08272025_00042.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 |
