| Invoice # | Today's Date | Company Name | Company Contact | Company Phone | Company Email | Rebate Status | Safety Inspection Date | Purchase/Invoice Date | Safety Inspector’s Full Name | Type of Installation | Total | How many rebates would you like to claim? | 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 | Total | 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 | Upload Proof of Purchase: | Name of Builder/Contractor | Upload Spec Sheet for Manufactured Home |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2025-22924179 | 04/20/2026 | Fitzgerald Utilities | Cecilia Smith | (229) 426-5440 | Email hidden; Javascript is required. | Submitted | 04/18/2026 | 04/15/2026 | CHRIS WOODS | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE199EP | TH.UA 123954 | 04/18/2026 | I-SERRANO_0001.pdf | $200.00 | FITZGERALD UTILITIES | JUSTIN SUMNER | P.O. BOX 667 FITZGERALD, Georgia 31750 Map It | Email hidden; Javascript is required. | (229) 426-5440 | ISIDRO SERRANO | (229) 425-1641 | 130 AGNER COURT FITZGERALD, Georgia 31750 Map It | 709 EWING FARM RD ASHBURN, Georgia 31714 Map It | I-SERRANO_00011.pdf | ||||||||||||||||||
| 2025-27553646 | 04/20/2026 | Conger LP gas Moultrie | Kyle Johnson | (229) 985-6942 | Email hidden; Javascript is required. | Submitted | 04/07/2026 | 04/07/2026 | Conner Seabolt | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180EP | WC.UA-023203 | 04/07/2026 | 3942_260420161456_001.pdf | $200.00 | Conger LP Gas Moultrie | Kyle Johnson | 3117 veterans parkway s Moultrie, Georgia 31768 Map It | Email hidden; Javascript is required. | (229) 985-6942 | Greg Key | (229) 891-1789 | Email hidden; Javascript is required. | 2052 RL Sears RD Norman Park, Georgia 31771 Map It | 2052 RL Sears RD Norman Park, Georgia 31771 Map It | 3942_260420161456_0011.pdf | |||||||||||||||||
| 2025-25533817 | 04/21/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Submitted | 04/02/2026 | 04/02/2026 | TY BROWN | New Construction | $200.00 | 1 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RX180IN/P | TG.BA-150686 | 04/02/2026 | COLEY.pdf | $200.00 | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | TIM COLEY BUILDER | (229) 886-1212 | 100 HAZELWOOD DRIVE LEESBURG, Georgia 31763 Map It | 100 HAZELWOOD DRIVE LEESBURG, Georgia 31763 Map It | TIM COLEY BUILDER | |||||||||||||||||||
| 2025-39366326 | 04/21/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Submitted | 04/06/2026 | 04/06/2026 | CURTIS HUNTER | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RX199IN/P | TL.BA-270165 | 04/06/2026 | stross.pdf | $200.00 | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | DIANDRA STROSS | (239) 841-0604 | 568 HWY 118 W SMITHVILLE, Georgia 31787 Map It | 568 HWY 118 W SMITHVILLE, Georgia 31787 Map It | stross1.pdf | ||||||||||||||||||
| 2025-89877182 | 04/21/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Submitted | 04/02/2026 | 04/02/2026 | ROYCE HUNTER | New Construction | $400.00 | 1 | Propane-Fueled Recirculating Water Heater ($400.00) | RINNAI | RXP199 | TF.BA-115314 | 04/02/2026 | beaver.pdf | $400.00 | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | RODGER BEAVER CONSTRUCTION | (229) 698-4951 | 87 FIVE FORKS RD SHELLMAN, Georgia 39886 Map It | 87 FIVE FORKS RD SHELLMAN, Georgia 39886 Map It | RODGER BEAVER CONSTRUCTION | |||||||||||||||||||
| 2025-36826535 | 04/21/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Submitted | 04/07/2026 | 04/07/2026 | CURTIS HUNTER | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RX199IN/P | TA.BA-006777 | 04/07/2026 | rucker.pdf | $200.00 | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | KELLY RUCKER | (229) 869-2699 | 217 E WALTON ST BACONTON, Georgia 31716 Map It | 217 E WALTON ST BACONTON, Georgia 31716 Map It | rucker1.pdf | ||||||||||||||||||
| 2025-41119165 | 04/21/2026 | PARTNERS PROPANE OF GA INC. | AMANDA ALBRITTON | (478) 862-4644 | Email hidden; Javascript is required. | Submitted | 04/20/2026 | 04/20/2026 | TYLER robinson | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | rinnai | re199ep | TgUA-108589 | 04/20/2026 | Invoice_20260420_0003.pdf | $200.00 | PARTNERS PROPANE OF GA | AMANDA ALBRITTON | PO BOX 277 BUTLER, Georgia 31006 Map It | Email hidden; Javascript is required. | (478) 862-4644 | DJ SPELL | (706) 580-9892 | 361 JOHNNY WAINWRIGHT RD BUTLER, Georgia 31006 Map It | 361 JOHNNY WAINWRIGHT RD BUTLER, Georgia 31006 Map It | Invoice_20260420_00031.pdf | ||||||||||||||||||
| 2025-11773699 | 04/21/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Submitted | 04/16/2026 | 04/16/2026 | MIKE BURLESON | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RX199IN | TH.BA-185341 | 04/16/2026 | FINCHER.pdf | $200.00 | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | FINCHER'S WOODWORK | (229) 894-3174 | 102 FRANK ORGEL CIRCLE ALBANY, Georgia 31721 Map It | 102 FRANK ORGEL CIRCLE ALBANY, Georgia 31721 Map It | FINCHER1.pdf | ||||||||||||||||||
| 2025-84530902 | 04/21/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Submitted | 04/17/2026 | 04/17/2026 | RICKY HUIRAS | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE160IP | TL.UA-161279 | 04/17/2026 | SKALLA.pdf | $200.00 | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | RUSTY SKALLA | (229) 886-2444 | 2501 DAYLOR COURT ALBANY, Georgia 31721 Map It | 2501 DAYLOR COURT ALBANY, Georgia 31721 Map It | SKALLA1.pdf | ||||||||||||||||||
| 2025-49614871 | 04/21/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Submitted | 04/20/2026 | 04/20/2026 | ROYCE HUNTER | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RX180IN/P | TG.BA-151859 | 04/20/2026 | ISLER.pdf | $200.00 | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | GEORGE ISLER | (336) 407-0589 | 4517 LACOSTA LANE ALBANY, Georgia 31721 Map It | 4517 LACOSTA LANE ALBANY, Georgia 31721 Map It | ISLER1.pdf | ||||||||||||||||||
| 2025-51235796 | 04/22/2026 | Conger LP GAS | christina Duncan | (912) 537-8722 | Email hidden; Javascript is required. | Submitted | 04/21/2026 | 03/17/2026 | Jonathan Mauldin | New Construction | $200.00 | 1 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180EP | TM.UA-176136 | 04/21/2026 | ANGELO.pdf | $200.00 | Conger LP GAS | Christina Duncan | 604 North Broadfoot Blvd Vidalia, Georgia 30474 Map It | Email hidden; Javascript is required. | (912) 537-8722 | Mary Angelo | (813) 514-7690 | 81 Shady Lane Swainsboro, Georgia 30401 Map It | 81 Shady Lane Swainsboro, Georgia 30401 Map It | Extreme Builders | |||||||||||||||||||
| 2025-95810212 | 04/22/2026 | Conger LP GAS | christina Duncan | (912) 537-8722 | Email hidden; Javascript is required. | Submitted | 04/21/2026 | 04/07/2026 | Jonathan Mauldin | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE160EP | WB.UA-012009 | 04/07/2026 | BLACKWELDER.pdf | $200.00 | Conger LP GAS | Christina Duncan | 604 North Broadfoot Blvd Vidalia, Georgia 30474 Map It | Email hidden; Javascript is required. | (912) 537-8722 | John Blackwelder | (904) 321-7875 | 4726 Ga HWY 15 Vidalia, Georgia 30474 Map It | 4726 Ga HWY 15 Vidalia, Georgia 30474 Map It | BLACKWELDER1.pdf | ||||||||||||||||||
| 2025-62215323 | 04/22/2026 | BATES GAS COMPANY | CHRSITINE FOWLER | (229) 436-5338 | Email hidden; Javascript is required. | Submitted | 04/01/2026 | 04/01/2026 | FLOYD BRANCH | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180EP | TM.UA-176107 | 04/01/2026 | bart-davis.pdf | $200.00 | BATES GAS COMPANY | CHRSITINE FOWLER | 2703 SYLVESTER RD ALBANY, Georgia 31705 Map It | Email hidden; Javascript is required. | (229) 436-5338 | BART DAVIS | (229) 881-2110 | 7861 THIGPIN TRAIL DOERUN, Georgia 31744 Map It | 7861 THIGPIN TRAIL DOERUN, Georgia 31744 Map It | bart-davis1.pdf | ||||||||||||||||||
| 2025-36947048 | 04/24/2026 | Conger LP | Debora Simning | (229) 776-7336 | Email hidden; Javascript is required. | Submitted | 04/13/2026 | 04/13/2026 | Levi Wilbanks | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180e | TM.UA-176120 | 04/13/2026 | $200.00 | Conger LP | Debora Simning | 306 S Main St Sylvester, Georgia 31791 Map It | Email hidden; Javascript is required. | (229) 776-7336 | Warrior Creek Mercantile | (229) 349-7403 | 1118 US HWY 82 E Sylvester, Georgia 31791 Map It | 1118 US HWY 82 E Sylvester, Georgia 31791 Map It | ||||||||||||||||||||
| 2025-41558755 | 04/24/2026 | Conger LP | Debora Simning | (229) 776-7336 | Email hidden; Javascript is required. | Submitted | 04/07/2026 | 04/07/2026 | Greg Bridges | New Construction | $200.00 | 1 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180e | TM.UA-176135 | 04/07/2026 | $200.00 | Conger LP | Debora Simning | 306 S Main St Sylvester, Georgia 31791 Map It | Email hidden; Javascript is required. | (229) 776-7336 | McDonald Construction | (229) 881-9477 | Email hidden; Javascript is required. | 3805 GA 313 N Sylvester, Georgia 31791 Map It | 217 Strangward Dr sylvester, Georgia 31791 Map It | Chad McDonald | |||||||||||||||||||
| 2025-77782941 | 04/24/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Submitted | 04/22/2026 | 04/22/2026 | Cole Truett | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE160eP | WC.UA-022377 | 04/22/2026 | 496-PATTEN_0552_260424115618_001.pdf | $200.00 | 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 | 496 Patten Watson Nashville, Georgia 31639 Map It | 496-PATTEN_0552_260424115618_0011.pdf | |||||||||||||||||
| 2025-64319978 | 04/24/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Submitted | 04/22/2026 | 04/22/2026 | Cole Truett | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE160eP | WC.UA-022381 | 04/22/2026 | 478-PATTEN_0553_260424115645_001.pdf | $200.00 | 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 | 478 Patten Watson Nashville, Georgia 31639 Map It | 478-PATTEN_0553_260424115645_0011.pdf | |||||||||||||||||
| 2025-58036293 | 04/24/2026 | Franklin Propane Gas, Inc. | Mike Franklin | (478) 552-6667 | Email hidden; Javascript is required. | Submitted | 04/24/2026 | 04/24/2026 | Jonathan Franklin | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RL75i | HH.CA-099895 | 04/24/2026 | MCDADE-REBATE.pdf | $200.00 | Franklin Propane Gas | Mike Franklin | P O Box 5890 Sandersville, Georgia 31082 Map It | Email hidden; Javascript is required. | (478) 552-6667 | Scott McDade | (478) 553-0775 | 1125 Plantation Drive Sandersville, Georgia 31082 Map It | 1125 Plantation Drive Sandersville, Georgia 31082 Map It | MCDADE-REBATE1.pdf | ||||||||||||||||||
| 2025-37393556 | 04/28/2026 | Conger LP GAS | christina Duncan | (912) 537-8722 | Email hidden; Javascript is required. | Submitted | 04/09/2026 | 04/09/2026 | Jonathan Mauldin | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE160EP | WB.UA-012880 | 04/09/2026 | SPIVEY.pdf | $200.00 | Conger LP GAS | Christina Duncan | 604 North Broadfoot Blvd Vidalia, Georgia 30474 Map It | Email hidden; Javascript is required. | (912) 537-8722 | Mary Spivey | (912) 293-2770 | 705 Adams St Vidalia, Georgia 30474 Map It | 705 Adams St Vidalia, Georgia 30474 Map It | SPIVEY1.pdf | ||||||||||||||||||
| 2025-10718361 | 04/28/2026 | HAROLDS PROPANE | HAROLD CAWTHON | (770) 775-4821 | Email hidden; Javascript is required. | Submitted | 04/27/2026 | 04/27/2026 | KEITH THOMPSON | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RHEEM | PROG40-32P-RH62 | 0322500661 | 04/27/2026 | Scan_20260428.pdf | $200.00 | HAROLDS PROPANE | HC HAROLD CAWTHON | P.O.BOX 219 162 stark rd. Jackson, Georgia 30233 Map It | Email hidden; Javascript is required. | (404) 535-0997 | JEFF BARNES | (678) 372-3343 | 1379 HALLSBRIDGE RD 137 JACKSON, Georgia 30233 Map It | 1379 HALLSBRIDGE RD 137 JACKSON, Georgia 30233 Map It | Scan_202604281.pdf | ||||||||||||||||||
| 2025-73107567 | 04/28/2026 | Conger LP gas Moultrie | Kyle Johnson | (229) 985-6942 | Email hidden; Javascript is required. | Submitted | 04/24/2026 | 04/24/2026 | Taylor Newsom | Replacement or New Appliance | $400.00 | 2 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE160EP | WB.UA-012010 | 04/24/2026 | 3999_260428104318_001.pdf | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE160EP | WB.UA-012007 | 04/24/2026 | 3999_260428104318_0011.pdf | $400.00 | Conger LP Gas Moultrie | Kyle Johnson | 3117 veterans parkway s Moultrie, Georgia 31768 Map It | Email hidden; Javascript is required. | (229) 985-6942 | Robin Stinson | (239) 454-9623 | Email hidden; Javascript is required. | 274 Whitfield Rd Moultrie, Georgia 31768 Map It | 274 Whitfield Rd Moultrie, Georgia 31768 Map It | 3999_260428104318_0012.pdf | |||||||||||
| 2025-76579518 | 04/28/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Submitted | 04/27/2026 | 04/27/2026 | Kevin Smoot | New Construction | $50.00 | 1 | Cooktop ($50.00) | Samsung | NSE6DG85505RAA | 06237DAY600110X | 04/27/2026 | img20260428_12214123.pdf | $50.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Arturo Ruiz | (770) 289-4267 | 515 Katherine Drive Jefferson, Georgia 30549 Map It | 515 Katherine Drive Jefferson, Georgia 30549 Map It | N/A | |||||||||||||||||||
| 2025-22123102 | 04/29/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Submitted | 04/24/2026 | 04/24/2026 | Cole Truett | Replacement or New Appliance | $400.00 | 2 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RSC199eP | RE.BA-064873 | 04/24/2026 | BROOKS-6073_0582_260429081247_001.pdf | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RL75eP | PC.CA-037370 | 04/24/2026 | BROOKS-6073_0582_260429081247_0011.pdf | $400.00 | 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 | Scott Brooks | (229) 563-5632 | Email hidden; Javascript is required. | 6073 Providence Point Hahira, Georgia 31632 Map It | 6073 Providence Point Hahira, Georgia 31632 Map It | BROOKS-6073_0582_260429081247_0012.pdf | |||||||||||
| 2025-61516162 | 04/29/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Submitted | 04/28/2026 | 04/28/2026 | Kevin Smoot | New Construction | $50.00 | 1 | Cooktop ($50.00) | JennAir | JGRP848H607 | DF0101481 | 04/28/2026 | img20260429_09282420.pdf | $50.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Alex Kharabora | (770) 653-4444 | 117 Kinney Creek Lane Pendergrass, Georgia 30567 Map It | 117 Kinney Creek Lane Pendergrass, Georgia 30567 Map It | N/A | |||||||||||||||||||
| 2025-31258447 | 04/29/2026 | Sikes Propane Inc | Daniel Sikes Jr | (912) 367-1151 | Email hidden; Javascript is required. | Submitted | 04/22/2026 | 04/22/2026 | DANIEL SIKES | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE199e | TL.UA-164967 | 04/22/2026 | HPSCAN_20260429140824007_2026-04-29_140911938-1-compressed.pdf | $200.00 | SIKES PROPANE INC. | SIKES PROPANE | 2174 HATCH PARKWAY SOUTH BAXLEY, Georgia 31513 Map It | Email hidden; Javascript is required. | (912) 367-1151 | KANDACE OQUINN | (912) 278-5796 | 1159 AZALEA RD BAXLEY, Georgia 31513 Map It | 1159 AZALEA RD BAXLEY, Georgia 31513 Map It | HPSCAN_20260429140824007_2026-04-29_140911938-1-compressed1.pdf | ||||||||||||||||||
| Invoice # | Today's Date | Company Name | Company Contact | Company Phone | Company Email | Rebate Status | Safety Inspection Date | Purchase/Invoice Date | Safety Inspector’s Full Name | Type of Installation | Total | How many rebates would you like to claim? | 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 | Total | 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 | Upload Proof of Purchase: | Name of Builder/Contractor | Upload Spec Sheet for Manufactured Home |
