| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2025-47484612 | 05/07/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Payment Sent | 05/06/2026 | 05/06/2026 | Kevin Smoot | New Construction | $250.00 | 2 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Bradford White | RTER199 | F2400119603 | 05/06/2026 | img20260507_16034035.pdf | Cooktop ($50.00) | Wolf | SRT484DE-1P | 19445125 | 05/06/2026 | img20260507_160340351.pdf | $250.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Bradley Shepherd | (770) 714-1989 | 2077 Mountain Creek Church Road Pendergrass, Georgia 30567 Map It | 2077 Mountain Creek Church Road Pendergrass, Georgia 30567 Map It | N/A | |||||||||||||
| 2025-95818424 | 05/08/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Payment Sent | 05/08/2026 | 05/08/2026 | Seth Weeks | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180eP | TL.UA-161564 | 05/08/2026 | CHANEY-807_0673_260508113843_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 | Chaney Custom Homes | (229) 560-8857 | Email hidden; Javascript is required. | 5505 Old US Hwy 41 S Lake Park, Georgia 31636 Map It | 807 Smithbriar Valdosta, Georgia 31601 Map It | CHANEY-807_0673_260508113843_0011.pdf | |||||||||||||||||
| 2025-56614540 | 05/08/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Payment Sent | 05/06/2026 | 05/06/2026 | Cole Truett | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE160eP | WC.UA-024179 | 05/06/2026 | OWENS_0674_260508113922_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 | 326 Barryfield Circle Hahira, Georgia 31632 Map It | OWENS_0674_260508113922_0011.pdf | |||||||||||||||||
| 2025-81149608 | 05/08/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 04/30/2026 | 04/30/2026 | CURTIS HUNTER | New Construction | $600.00 | 2 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | CX199IN/P | TJ.BA-210320 | 04/30/2026 | VCA.pdf | Propane-Fueled Recirculating Water Heater ($400.00) | RINNAI | RXP199 | TJ.BA-211966 | 04/30/2026 | VCA1.pdf | $600.00 | MODERN GAS COMPANY | MARK HOLLOWAY | 1335 US HWY 82 EST LEESBURG, Georgia 31763 Map It | Email hidden; Javascript is required. | (229) 435-6116 | VCA CONSTRUCTION | (229) 234-2402 | 1425 US 19 SOUTH LEESBURG, Georgia 31763 Map It | 1425 US 19 SOUTH LEESBURG, Georgia 31763 Map It | VCA | |||||||||||||
| 2025-33502121 | 05/11/2026 | PARTNERS PROPANE OF GA INC. | AMANDA ALBRITTON | (478) 862-4644 | Email hidden; Javascript is required. | Payment Sent | 05/01/2026 | 05/01/2026 | tyler robinson | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180EP | WC.UA-030398 | 05/01/2026 | Invoice_20260501_0002.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 | ANDY/ROBIN ROBINSON | (478) 862-5336 | 1289 ROBERTA HWY BUTLER, Georgia 31006 Map It | 1289 ROBERTA HWY BUTLER, Georgia 31006 Map It | Invoice_20260501_00021.pdf | ||||||||||||||||||
| 2025-57517507 | 05/11/2026 | Conger LP GAS | christina Duncan | (912) 537-8722 | Email hidden; Javascript is required. | Payment Sent | 04/27/2026 | 04/27/2026 | Jonathan Mauldin | Replacement or New Appliance | $400.00 | 2 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180EP | WC.UA-030399 | 04/27/2026 | ECKERT_20260511_0001.pdf | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180EP | TM.UA-176137 | 04/27/2026 | ECKERT_20260511_00011.pdf | $400.00 | Conger LP GAS | Christina Duncan | 604 North Broadfoot Blvd Vidalia, Georgia 30474 Map It | Email hidden; Javascript is required. | (912) 537-8722 | Alena Eckert | (631) 317-9075 | 945 Taylor Springs Rd Vidalia, Georgia 30474 Map It | 945 Taylor Springs Rd Vidalia, Georgia 30474 Map It | ECKERT_20260511_00012.pdf | ||||||||||||
| 2025-47185463 | 05/11/2026 | Conger LP GAS | christina Duncan | (912) 537-8722 | Email hidden; Javascript is required. | Payment Sent | 04/30/2026 | 04/30/2026 | Jonathan Mauldin | New Construction | $200.00 | 1 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RXP160IN | SM.BA-209660 | 04/30/2026 | MOCK_20260511_0001.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 | Mitchell Mock | (912) 667-2345 | 4221 HWY 219 Pembroke, Georgia 31321 Map It | 4221 HWY 219 Pembroke, Georgia 31321 Map It | Olive Tree Builders | |||||||||||||||||||
| 2025-74713872 | 05/12/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 05/05/2026 | 05/05/2026 | Owens Vinyl | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE160eP | WC.UA-022375 | 05/05/2026 | OWENS-310_0699_260512083331_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 | 310 Barryfield Circle Hahira, Georgia 31632 Map It | OWENS-310_0699_260512083331_0011.pdf | |||||||||||||||||
| 2025-66162851 | 05/12/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Payment Sent | 05/08/2026 | 05/08/2026 | Cole Truett | Replacement or New Appliance | $400.00 | 2 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180eP | TM.UA-172945 | 05/08/2026 | BUILDING-3009_0700_260512083407_001.pdf | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180eP | TM.UA-172953 | 05/08/2026 | BUILDING-3009_0700_260512083407_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 | Building Valdosta | (229) 740-0978 | Email hidden; Javascript is required. | 231 Northside Drive Valdosta, Georgia 31602 Map It | 3009 Mary Powell Hahira, Georgia 31632 Map It | BUILDING-3009_0700_260512083407_0012.pdf | |||||||||||
| 2025-47796216 | 05/12/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Processing | 05/07/2026 | 05/07/2026 | Owen Dills | New Construction | $50.00 | 1 | Cooktop ($50.00) | GE | PGP7036SL555 | FD062991Q | 05/07/2026 | img20260512_12353897.pdf | $50.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Orlando Miguez | (770) 826-4831 | 205 Chariot Court Jefferson, Georgia 30549 Map It | 205 Chariot Court Jefferson, Georgia 30549 Map It | N/A | |||||||||||||||||||
| 2025-63476496 | 05/12/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Payment Sent | 05/08/2026 | 05/08/2026 | Kevin Smoot | New Construction | $50.00 | 1 | Cooktop ($50.00) | THOR | ARD4803ULP | U02591218 | 05/08/2026 | img20260512_14182809.pdf | $50.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Mark Burdick | (678) 612-3365 | 4438 Locklin Road Monroe, Georgia 30655 Map It | 4438 Locklin Road Monroe, Georgia 30655 Map It | N/A | |||||||||||||||||||
| 2025-35994463 | 05/12/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Processing | 05/11/2026 | 05/11/2026 | Kevin Smoot | New Construction | $50.00 | 1 | Cooktop ($50.00) | KitchenAid | KFG593655500 | DE5102712 | 05/11/2026 | img20260512_15313735.pdf | $50.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Chandler Payne | (770) 530-0759 | 1856 Rock Springs Road Alto, Georgia 30510 Map It | 1856 Rock Springs Road Alto, Georgia 30510 Map It | N/A | |||||||||||||||||||
| 2025-25022826 | 05/12/2026 | Barfield Gas Company, Inc. | Michael Davis | (229) 896-4828 | Email hidden; Javascript is required. | Payment Sent | 05/06/2026 | 05/05/2026 | Caleb Harnage | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE199eP | WC.UA-026409 | 05/06/2026 | REBATE-MTOLIVE.pdf | $200.00 | Barfield Gas Company | Michael Davis | PO BOX 990 PO BOX 990 Adel, Georgia 31620 Map It | Email hidden; Javascript is required. | (229) 896-4828 | MT. OLIVE BAPTIST CHURCH MT. OLIVE BAPTIST CHURCH | (229) 921-1801 | 172 MT. OLIVE CHURCH RD MOULTRIE, Georgia 31776 Map It | 172 MT. OLIVE CHURCH RD MOULTRIE, Georgia 31776 Map It | REBATE-MTOLIVE1.pdf | ||||||||||||||||||
| 2025-15547811 | 05/13/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Submitted | 05/12/2026 | 05/12/2026 | Owen Dills | New Construction | $50.00 | 1 | Cooktop ($50.00) | Forno | FPSG56460-48 | 24090019 | 05/12/2026 | img20260513_15185207.pdf | $50.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Jesus Taborda | (706) 380-4611 | 4427 Pond Fork Church Road Pendergrass, Georgia 30567 Map It | 4427 Pond Fork Church Road Pendergrass, Georgia 30567 Map It | N/A | |||||||||||||||||||
| 2025-10766869 | 05/13/2026 | Conger LP gas Moultrie | Kyle Johnson | (229) 985-6942 | Email hidden; Javascript is required. | Submitted | 05/08/2026 | 05/08/2026 | Conner Seabolt | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180EP | WC.UA-026952 | 05/08/2026 | 4148_260513153225_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 | Rett Thomas | (229) 873-8999 | Email hidden; Javascript is required. | 918 JO Stewart Rd Norman Park, Georgia 31771 Map It | 918 JO Stewart Rd Norman Park, Georgia 31771 Map It | 4148_260513153225_0011.pdf | |||||||||||||||||
| 2025-86724957 | 05/13/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Submitted | 05/12/2026 | 05/12/2026 | Owen Dills | New Construction | $50.00 | 1 | Cooktop ($50.00) | ZLINE | RA48 | RA48GE21120828-03 | 05/12/2026 | img20260513_15572514.pdf | $50.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Jim Moreland | (678) 446-8142 | 723 Rambler Inn Road Jefferson, Georgia 30549 Map It | 723 Rambler Inn Road Jefferson, Georgia 30549 Map It | N/A | |||||||||||||||||||
| 2025-12552382 | 05/13/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Submitted | 05/12/2026 | 05/12/2026 | Owen Dills | New Construction | $450.00 | 2 | Propane furnace, or gas pack ($400.00) | Trane | DGAA056BDJD | WIG6744232 | 05/12/2026 | img20260513_16175570.pdf | Cooktop ($50.00) | Magic Chef | 6257XUS | 15759768MK | 05/12/2026 | img20260513_161755701.pdf | $450.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | David Underwood | (706) 654-7104 | 1814 Mountain Creek Drive Pendergrass, Georgia 30567 Map It | 1814 Mountain Creek Drive Pendergrass, Georgia 30567 Map It | N/A | |||||||||||||
| 2025-10831530 | 05/14/2026 | Webb Brothers Propane, Inc | Kristy Gamble | (229) 382-0789 | Email hidden; Javascript is required. | Submitted | 05/14/2026 | 05/14/2026 | MICHAEL WEBB | New Construction | $200.00 | 1 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180EP | TD.UA-060367 | 05/14/2026 | MITT-PATEL.pdf | $200.00 | Webb Brothers Propane, Inc | Kristy Gamble | PO Drawer 7269 3615 Hwy 82 W Tifton, Georgia 31793 Map It | Email hidden; Javascript is required. | (229) 382-0789 | MITT PATEL | (229) 785-2704 | 1045 GA HWY 133 N MOULTRIE, Georgia 31768 Map It | 1045 GA HWY 133 N MOULTRIE, Georgia 31768 Map It | SELF | |||||||||||||||||||
| 2025-91863361 | 05/14/2026 | Conger LP GAS | christina Duncan | (912) 537-8722 | Email hidden; Javascript is required. | Submitted | 05/12/2026 | 04/12/2026 | Jonathan Mauldin | New Construction | $200.00 | 1 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180EP | TJ.UA-128350 | 04/12/2026 | CARTER.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 | Zach Carter | (912) 278-5586 | 3542 Ga Hwy 152 Lyons, Georgia 30436 Map It | 3542 Ga Hwy 152 Lyons, Georgia 30436 Map It | Mckenzie Builders Greg | |||||||||||||||||||
| 2025-31487563 | 05/14/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Submitted | 05/13/2026 | 05/13/2026 | Kevin Smoot | New Construction | $50.00 | 1 | Cooktop ($50.00) | Magic Chef | U31DA-7 | 292198 | 05/13/2026 | img20260514_13075613.pdf | $50.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Midge Sexton | (706) 654-3587 | 111 Jackson Way Jefferson, Georgia 30549 Map It | 111 Jackson Way Jefferson, Georgia 30549 Map It | N/A | |||||||||||||||||||
| 2025-53975282 | 05/15/2026 | Webb Brothers Propane, Inc | Kristy Gamble | (229) 382-0789 | Email hidden; Javascript is required. | Submitted | 05/14/2026 | 05/14/2026 | ROBERT COTHREN | Replacement or New Appliance | $200.00 | 1 | Conversion | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180EP | WA-UA.004014 | 05/14/2026 | DUSTY-BEATY.pdf | $200.00 | Webb Brothers Propane, Inc | Kristy Gamble | PO Drawer 7269 3615 Hwy 82 W Tifton, Georgia 31793 Map It | Email hidden; Javascript is required. | (229) 382-0789 | DUSTY BEATY | (229) 445-0270 | 538 HWY 32 E SYCAMORE, Georgia 31790 Map It | 538 HWY 32 E SYCAMORE, Georgia 31790 Map It | DUSTY-BEATY1.pdf | ||||||||||||||||||
| 2025-53286161 | 05/15/2026 | Conger LP | Debora Simning | (229) 776-7336 | Email hidden; Javascript is required. | Submitted | 05/14/2026 | 05/14/2026 | James Seabolt | New Construction | $200.00 | 1 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180e | TL.UA-163695 | 05/14/2026 | $200.00 | Conger LP | Debora Simning | 306 S Main St Sylvester, Georgia 31791 Map It | Email hidden; Javascript is required. | (229) 776-7336 | CHAD MCDONALD CONSTRUCTION | (229) 881-9477 | Email hidden; Javascript is required. | 3805 GA 313 N SYLVESTER, Georgia 31791 Map It | Mcdonald Construction #4 Sawtooth Oaks Leesburg, Georgia 31763 Map It | Mcdonald Construction | |||||||||||||||||||
| 2025-77286404 | 05/15/2026 | Conger LP | Debora Simning | (229) 776-7336 | Email hidden; Javascript is required. | Submitted | 05/14/2026 | 05/14/2026 | james seabolt | New Construction | $200.00 | 1 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180e | TM.UA-176132 | 05/14/2026 | $200.00 | Conger LP | Debora Simning | 306 S Main St Sylvester, Georgia 31791 Map It | Email hidden; Javascript is required. | (229) 776-7336 | CHAD MCDONALD CONSTRUCTION | (229) 881-9477 | Email hidden; Javascript is required. | 3805 GA 313 N SYLVESTER, Georgia 31791 Map It | 3805 GA 313 N SYLVESTER, Georgia 31791 Map It | CHAD MCDONALD CONSTRUCTION | |||||||||||||||||||
| 2025-31183633 | 05/15/2026 | Sikes Propane Inc | Daniel Sikes Jr | (912) 367-1151 | Email hidden; Javascript is required. | Submitted | 05/14/2026 | 05/14/2026 | DANIEL SIKES | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RL75e | PC.CA-040997 | 05/14/2026 | HPSCAN_2026051518063442_2026-05-15_180722040-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 | BRENDA MURRAY | (912) 339-3011 | 1049 FIRESTATION RD BAXLEY, Georgia 31513 Map It | 1049 FIRESTATION RD BAXLEY, Georgia 31513 Map It | HPSCAN_2026051518063442_2026-05-15_180722040-compressed1.pdf | ||||||||||||||||||
| 2025-56652393 | 05/15/2026 | Conger LP | Debora Simning | (229) 776-7336 | Email hidden; Javascript is required. | Submitted | 05/01/2026 | 05/01/2026 | James seabolt | New Construction | $200.00 | 1 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RX180i | TM.BA-276916 | 05/01/2026 | $200.00 | Conger LP | Debora Simning | 306 S Main St Sylvester, Georgia 31791 Map It | Email hidden; Javascript is required. | (229) 776-7336 | Marcus Fletcher Construction | (229) 347-0845 | Email hidden; Javascript is required. | 129 N Main St Sylvester, Georgia 31791 Map It | 129 N Main St Sylvester, Georgia 31791 Map It | Marcus Fletcher Construction | |||||||||||||||||||
| 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 |
