| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2025-90417564 | 06/10/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 06/03/2026 | 06/03/2026 | TY BROWN | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE160EP | WC.UA-024248 | 06/03/2026 | BUTLER.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 | BUTLER CONSTRUCTION | (229) 894-5002 | 2219 CAMDEN LANE ALBANY, Georgia 31721 Map It | 2219 CAMDEN LANE ALBANY, Georgia 31721 Map It | BUTLER1.pdf | ||||||||||||||||||
| 2025-26132955 | 06/10/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 06/01/2026 | 06/01/2026 | ROYCE HUNTER | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RX160IN/P | TJ.BA-211130 | 06/01/2026 | AMATO.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 | ANTHONY & NANCY AMATO | (229) 376-2363 | 208 FAIRETHORNE DR LEESBURG, Georgia 31763 Map It | 208 FAIRETHORNE DR LEESBURG, Georgia 31763 Map It | AMATO1.pdf | ||||||||||||||||||
| 2025-16822205 | 06/10/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 06/02/2026 | 06/02/2026 | RICKY HUIRAS | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180EP | WC.UA-026853 | 06/02/2026 | ROLLAND.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 | BRIAN ROLLAND | (229) 407-2830 | 456 WIREGRASS WAY ALBANY, Georgia 31721 Map It | 456 WIREGRASS WAY ALBANY, Georgia 31721 Map It | ROLLAND1.pdf | ||||||||||||||||||
| 2025-73958648 | 06/10/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 06/03/2026 | 06/03/2026 | TY BROWN | New Construction | $400.00 | 2 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180EP | WC.UA-024984 | 06/03/2026 | VANCLEAVE.pdf | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180EP | WD.UA-037723 | 06/03/2026 | VANCLEAVE1.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 | VANCLEAVE CONSTRUCTION | (229) 869-1432 | 111 PARTRIDGE CIRCLE LEESBURG, Georgia 31763 Map It | 111 PARTRIDGE CIRCLE LEESBURG, Georgia 31763 Map It | VANCLEAVE CONSTRUCTION | |||||||||||||
| 2025-90594356 | 06/10/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 06/03/2026 | 06/03/2026 | TY BROWN | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180EP | WD.UA-037724 | 06/03/2026 | NOLAND.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 | JAMISON NOLAND | (229) 407-0265 | 701 STATE HWY 195 LEESBURG, Georgia 31763 Map It | 701 STATE HWY 195 LEESBURG, Georgia 31763 Map It | NOLAND1.pdf | ||||||||||||||||||
| 2025-96455293 | 06/10/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 06/03/2026 | 06/03/2026 | MIKE BURLESON | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180EP | WC.UA-025029 | 06/03/2026 | WRIGHT.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 | ROBERT WRIGHT | (229) 344-1251 | 262 WILLOW LAKE DR LEESBURG, Georgia 31763 Map It | 262 WILLOW LAKE DR LEESBURG, Georgia 31763 Map It | WRIGHT1.pdf | ||||||||||||||||||
| 2025-55003391 | 06/10/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 06/02/2026 | 06/02/2026 | TY BROWN | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE160IP | TM.UA-179208 | 06/02/2026 | $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 | AL & NELL BREEDLOVE | (229) 881-2141 | 2395 DOVEREL HWY 45 DAWSON, Georgia 39842 Map It | 2395 DOVEREL HWY 45 DAWSON, Georgia 39842 Map It | BREEDLOVE2.pdf | |||||||||||||||||||
| 2025-36211390 | 06/10/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 05/30/2026 | 05/30/2026 | ROYCE HUNTER | Replacement or New Appliance | $600.00 | 3 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | CX199IN/P | TJ.BA-217464 | 05/30/2026 | mrc.pdf | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | CX199IN/P | TJ.BA-217462 | 05/30/2026 | mrc1.pdf | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | CX199IN/P | TG.BA-169704 | 05/30/2026 | mrc2.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 | MRC SERVICES | (229) 894-3892 | 4419 GA HWY 112 S BRIDGEBORO, Georgia 31705 Map It | 4419 GA HWY 112 S BRIDGEBORO, Georgia 31705 Map It | mrc3.pdf | ||||||
| 2025-27470474 | 06/10/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 05/31/2026 | 05/31/2026 | TY BROWN | New Construction | $200.00 | 1 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180IP | TK.UA-156639 | 05/31/2026 | 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 | 128 HAZELWOOD DR LEESBURG, Georgia 31763 Map It | 128 HAZELWOOD DR LEESBURG, Georgia 31763 Map It | TIM COLEY BUILDER | |||||||||||||||||||
| 2025-33016100 | 06/10/2026 | Modern Gas Company, Inc. | Mark Holloway | (229) 435-6116 | Email hidden; Javascript is required. | Payment Sent | 06/05/2026 | 06/05/2026 | RICKY JARRELL | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | REP160IP | PG.UA-050717 | 06/05/2026 | lamon.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 | LAMON COMPANY | (229) 288-4276 | 241 MILLER ROAD LEESBURG, Georgia 31763 Map It | 241 MILLER ROAD LEESBURG, Georgia 31763 Map It | lamon1.pdf | ||||||||||||||||||
| 2025-20430822 | 06/10/2026 | Conger LP | Debora Simning | (229) 776-7336 | Email hidden; Javascript is required. | Payment Sent | 05/29/2026 | 05/29/2026 | James seabolt | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180e | TM.UA-176131 | 05/29/2026 | $200.00 | Conger LP | Debora Simning | 306 S Main St Sylvester, Georgia 31791 Map It | Email hidden; Javascript is required. | (229) 776-7336 | Austin Haralson | (229) 206-3331 | Email hidden; Javascript is required. | 3280 HWY 256 Sylvester, Georgia 31791 Map It | 3280 HWY 256 Sylvester, Georgia 31791 Map It |  | ||||||||||||||||||
| 2025-75862233 | 06/10/2026 | Conger LP Gas | Charlie Vining | (912) 501-3009 | Email hidden; Javascript is required. | Payment Sent | 06/09/2026 | 06/09/2026 | Charlie Vining | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180eP | WC.UA-034447 | 06/09/2026 | Lucas-Cason-Rinnai-Rebate.pdf | $200.00 | Conger LP Gas | Charlie Vining | 217 Thompson Dr Douglas, Georgia 31533 Map It | Email hidden; Javascript is required. | (912) 501-3009 | Lucas Cason | (912) 663-5955 | 77 Collier Dr Broxton, Georgia 31519 Map It | 77 Collier Dr Broxton, Georgia 31519 Map It | Lucas-Cason-Rinnai-Rebate1.pdf | ||||||||||||||||||
| 2025-88673190 | 06/10/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Payment Sent | 06/05/2026 | 06/05/2026 | Dillion Payne | New Construction | $50.00 | 1 | Cooktop ($50.00) | LG | LS665831F | 512MM560X462 | 06/05/2026 | img06102026_0033.pdf | $50.00 | Folger Gas | Stacy Mullinax | 4955 Application Hwy Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | John Hritz DBA Normandy Properties LLC | (404) 394-2526 | Email hidden; Javascript is required. | 1952 Paces Landing Court NW Conyers, Georgia 30012 Map It | 257 Gallery Ct Ellijay, Georgia 30540 Map It | John Kritz | ||||||||||||||||||
| 2025-23839677 | 06/10/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Payment Sent | 06/01/2026 | 06/01/2026 | Alvin Wilcox | New Construction | $250.00 | 2 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | TJ.Ba-209590 | Reu-NB3237ffus1717 | 06/01/2026 | img06102026_0034.pdf | Cooktop ($50.00) | GE | GG5500sn2ss | GD166900 | 06/01/2026 | img06102026_00341.pdf | $250.00 | Folger Gas | Stacy Mullinax | 4955 Application Hwy Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | Kathleen Reed | (225) 978-7717 | Email hidden; Javascript is required. | 217 Bell Rd Mineral Bluff, Georgia 30559 Map It | 217 Bell Rd Mineral Bluff, Georgia 30559 Map It | n/a | ||||||||||||
| 2025-44392766 | 06/10/2026 | Barfield Gas Company, Inc. | Michael Davis | (229) 896-4828 | Email hidden; Javascript is required. | Payment Sent | 06/02/2026 | 06/02/2026 | Caleb Harnage | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE199eP | WC.UA-027712 | 06/02/2026 | REBATE-TWILLIAMS.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 | TRIPP WILLIAMS | (229) 561-1438 | 2005 ANTIOCH RD ADEL, Georgia 31620 Map It | 2005 ANTIOCH RD ADEL, Georgia 31620 Map It | REBATE-TWILLIAMS1.pdf | ||||||||||||||||||
| 2025-25835473 | 06/10/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Payment Sent | 06/01/2026 | 06/01/2026 | Dillion Payne | Replacement or New Appliance | $50.00 | 1 | Conversion | Cooktop ($50.00) | Viking | V61C52626B5501 | 272223CL0096752 | 06/01/2026 | img06172026_0003.pdf | $50.00 | Folger Gas | Stacy Mullinax | 4955 Application Hwy Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | Kevin Moody | (404) 456-8289 | Email hidden; Javascript is required. | PO Box 465 Ellijay, Georgia 30536 Map It | 1902 Highway 382W Ellijay, Georgia 30540 Map It | img06102026_00351.pdf | |||||||||||||||||
| 2025-76548277 | 06/10/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Payment Sent | 06/01/2026 | 06/01/2026 | Jamie Cochran | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | REUVC2528FFUDUS | PHCA121771 | 06/01/2026 | img06102026_0036.pdf | $200.00 | Folger Gas | Stacy Mullinax | 4955 Application Hwy Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | Kenneth Schultz | (786) 282-5601 | Email hidden; Javascript is required. | 464 Arrowood Landing Blairsville, Georgia 30512 Map It | 464 Arrowood Landing Blairsville, Georgia 30512 Map It | img06102026_00361.pdf | |||||||||||||||||
| 2025-95272778 | 06/11/2026 | Conger LP gas Moultrie | Kyle Johnson | (229) 985-6942 | Email hidden; Javascript is required. | Submitted | 06/09/2026 | 06/09/2026 | Taylor Newsome | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180EP | WC.UA-023208 | 06/09/2026 | 4366_260611100844_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 | Rick Bushatz | (229) 921-7269 | Email hidden; Javascript is required. | 1419 us 319s Moultrie, Georgia 31768 Map It | 1419 us 319s Moultrie, Georgia 31768 Map It | 4366_260611100844_0011.pdf | |||||||||||||||||
| 2025-52816571 | 06/11/2026 | Webb Brothers Propane, Inc | Kristy Gamble | (229) 382-0789 | Email hidden; Javascript is required. | Submitted | 06/11/2026 | 06/11/2026 | Kristy Gamble | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | V53DEP | TE.CA-003053 | 06/11/2026 | DAVID-FLAKE.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 | DAVID FLAKE | (229) 567-1026 | 115 NORMAN CIRCLE CHULA, Georgia 31733 Map It | 115 NORMAN CIRCLE CHULA, Georgia 31733 Map It | DAVID-FLAKE1.pdf | ||||||||||||||||||
| 2025-46018336 | 06/11/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Submitted | 06/11/2026 | 06/11/2026 | Richard McCranie | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE160eP | WD.UA-038708 | 06/11/2026 | ACCELERATED-3921_1018_260611131955_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 | Accelerated Builders | (229) 256-5996 | Email hidden; Javascript is required. | 505 S Church St #6 Suite B Hahira, Georgia 31632 Map It | 3921 Bull Run Valdosta, Georgia 31605 Map It | ACCELERATED-3921_1018_260611131955_0011.pdf | |||||||||||||||||
| 2025-58109011 | 06/11/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Submitted | 06/11/2026 | 06/11/2026 | Zach Adams | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE160eP | WC.UA-024172 | 06/11/2026 | WEAVER-3891_1017_260611131604_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 | Classic Homes By Weaver | (229) 563-5365 | Email hidden; Javascript is required. | 237 Northside Drive Valdosta, Georgia 31601 Map It | 3891 Lu Lane Hahira, Georgia 31632 Map It | WEAVER-3891_1017_260611131604_0011.pdf | |||||||||||||||||
| 2025-80810451 | 06/11/2026 | Barfield Gas Company, Inc. | Michael Davis | (229) 896-4828 | Email hidden; Javascript is required. | Submitted | 05/28/2026 | 05/28/2026 | Caleb Harnage | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE199eP | WC.UA-026405 | 05/28/2026 | REBATE-BSTONE.57983.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 | BRIAN STONE | (229) 896-2336 | 227 LENOX BROOKFIELD RD LENOX, Georgia 31637 Map It | 227 LENOX BROOKFIELD RD LENOX, Georgia 31637 Map It | REBATE-BSTONE.579831.pdf | ||||||||||||||||||
| 2025-82686832 | 06/11/2026 | Barfield Gas Company, Inc. | Michael Davis | (229) 896-4828 | Email hidden; Javascript is required. | Submitted | 05/29/2026 | 05/29/2026 | Caleb Harnage | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180eP | TJ.UA-130033 | 05/29/2026 | REBATE-KBROWNING.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 | KARMEN BROWNING | (229) 300-3583 | 4581 TILLMAN BLUFF VALDOSTA, Georgia 31602 Map It | 4581 TILLMAN BLUFF VALDOSTA, Georgia 31602 Map It | REBATE-KBROWNING1.pdf | ||||||||||||||||||
| 2025-18711773 | 06/12/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Submitted | 06/02/2026 | 06/02/2026 | Alvin Wilcox | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Navien | NPE15052 | 2075u2562319743 | 06/02/2026 | img06122026_0002.pdf | $200.00 | Folger Gas | Stacy Mullinax | 4955 Appalachian Highway Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | Jody Wilson | (706) 455-6408 | 175 Loving Meadows Lane Morganton, Georgia 30560 Map It | Clay's Way Lot #6 Blue Ridge, Georgia 30513 Map It | img06122026_00021.pdf | ||||||||||||||||||
| 2025-61079916 | 06/12/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Submitted | 06/12/2026 | 06/12/2026 | Kevin Smoot | New Construction | $50.00 | 1 | Cooktop ($50.00) | Bertazzoni | MA5486GCASNEV | 1224019923 | 06/12/2026 | img20260612_14370868.pdf | $50.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Tom Duncan | (678) 428-2296 | 7342 Eagle Court Jefferson, Georgia 30549 Map It | 7342 Eagle Court Jefferson, Georgia 30549 Map It | N/A | |||||||||||||||||||
| 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 |
