| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2025-14789448 | 06/12/2026 | Franklin Propane Gas, Inc. | Mike Franklin | (478) 552-6667 | Email hidden; Javascript is required. | Submitted | 06/10/2026 | 06/10/2026 | Jonathan Franklin | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE 180EP | WD.UA-036309 | 06/10/2026 | MCGEE-RECEIPT.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 | Brett McGee | (561) 602-9050 | 9650 Harrison-Davisboro Road Harrison, Georgia 31035 Map It | 9650 Harrison-Davisboro Road Harrison, Georgia 31035 Map It | MCGEE-RECEIPT1.pdf | ||||||||||||||||||
| 2025-42459396 | 06/16/2026 | BATES GAS COMPANY | CHRSITINE FOWLER | (229) 436-5338 | Email hidden; Javascript is required. | Submitted | 06/02/2026 | 06/02/2026 | FLOYD BRANCH | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180IP | TB.UA-027402 | 06/02/2026 | mattmillerrebate.pdf | $200.00 | BATES GAS COMPANY | CHRSITINE FOWLER | 2703 SYLVESTER RD ALBANY, Georgia 31705 Map It | Email hidden; Javascript is required. | (229) 436-5338 | MATT MILLER | (229) 347-0668 | 4914 MILLSBEE CIRCLE ALBANY, Georgia 31721 Map It | 4914 MILLSBEE CIRCLE ALBANY, Georgia 31721 Map It | mattmillerrebate1.pdf | ||||||||||||||||||
| 2025-19006465 | 06/16/2026 | PARTNERS PROPANE OF GA INC. | AMANDA ALBRITTON | (478) 862-4644 | Email hidden; Javascript is required. | Submitted | 06/16/2026 | 06/16/2026 | TYLER ROBINSON | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | re180e | tb-ua-022621 | 06/16/2026 | Invoice_20260616_0002.pdf | $200.00 | PARTNERS PROPAN E | AMANDA ALBRITTON | PO BOX 277 BUTLER, Georgia 31006 Map It | Email hidden; Javascript is required. | (478) 862-4644 | SHELDON HOLLAND | (941) 800-7070 | 478 BARROW RD REYNOLDS, Georgia 31076 Map It | 378 BARROW RD REYNOLDS, Georgia 31076 Map It | Invoice_20260616_00021.pdf | ||||||||||||||||||
| 2025-20783305 | 06/16/2026 | Barfield Gas Company, Inc. | Michael Davis | (229) 896-4828 | Email hidden; Javascript is required. | Submitted | 06/09/2026 | 05/26/2026 | Caleb Harnage | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | REP199eP | WD.UA-045622 | 06/09/2026 | REBATE-SMOORE-57994.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 | SHAWN MOORE | (229) 977-8040 | 3976 TIMBER RIDGE RD VALDOSTA, Georgia 31601 Map It | 3976 TIMBER RIDGE RD VALDOSTA, Georgia 31601 Map It | REBATE-SMOORE-579941.pdf | ||||||||||||||||||
| 2025-93821507 | 06/17/2026 | Conger LP Gas | Lee Phillips | (229) 386-5574 | Email hidden; Javascript is required. | Submitted | 06/15/2026 | 06/15/2026 | Justin Seabolt | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180eP | WD.UA-040079 | 06/15/2026 | 3765_001.pdf | $200.00 | Conger LP Gas | Lee Mathews | 146 S. RIDGE AVE. TIFTON, Georgia 31794 Map It | Email hidden; Javascript is required. | (229) 386-5574 | Vernon Poole | (601) 466-6107 | Email hidden; Javascript is required. | 969 Firetower Rd. Enigma, Georgia 31749 Map It | 969 Firetower Rd. Enigma, Georgia 31749 Map It | 3765_0011.pdf | |||||||||||||||||
| 2025-23497086 | 06/17/2026 | Conger LP Gas | Lee Phillips | (229) 386-5574 | Email hidden; Javascript is required. | Submitted | 05/20/2026 | 05/20/2026 | Justin Seabolt | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE160eP | TG.UA-098208 | 05/20/2026 | 3766_001.pdf | $200.00 | Conger LP Gas | Lee Mathews | 146 S. RIDGE AVE. Tifton, Georgia 31794 Map It | Email hidden; Javascript is required. | (229) 386-5574 | Johnny Griffin | (229) 237-5066 | Email hidden; Javascript is required. | 111 Chaserville Rd. Nashville, Georgia 31639 Map It | 111 Chaserville Rd. Nashville, Georgia 31639 Map It | 3766_0011.pdf | |||||||||||||||||
| 2025-55106776 | 06/17/2026 | Conger LP Gas | Lee Phillips | (229) 386-5574 | Email hidden; Javascript is required. | Submitted | 06/01/2026 | 06/01/2026 | Justin Seabolt | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180eP | TL.UA-163735 | 06/01/2026 | 3768_001.pdf | $200.00 | Conger LP Gas | Lee Mathews | 146 S. RIDGE AVE. TIFTON, Georgia 31794 Map It | Email hidden; Javascript is required. | (229) 386-5574 | Lewis Taylor Farms | (229) 821-0093 | Email hidden; Javascript is required. | 1616 W.B. Parks Rd. Tifton, Georgia 31793 Map It | 1616 W.B. Parks Rd. Tifton, Georgia 31793 Map It | 3768_0011.pdf | |||||||||||||||||
| 2025-13938318 | 06/17/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Submitted | 06/12/2026 | 06/12/2026 | Dillon Payne | New Construction | $200.00 | 1 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | Reuvc2528ffudus | Paca017378 | 06/12/2026 | img06172026_0005.pdf | $200.00 | Folger Gas | Stacy Mullinax | 4955 Appalachian Highway Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | Miles Johnson | (706) 455-8678 | Email hidden; Javascript is required. | 1845 Lebanon Rd Epworth, Georgia 30541 Map It | Scenic Dr. Blue Ridge, Georgia 30513 Map It | n/a | ||||||||||||||||||
| 2025-92368979 | 06/17/2026 | Conger LP GAS | christina Duncan | (912) 537-8722 | Email hidden; Javascript is required. | Submitted | 05/28/2026 | 05/24/2026 | Jonathan Mauldin | New Construction | $200.00 | 1 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RX160in | TK.BA-252175 | 05/24/2026 | HENRY.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 | Eric Henry | (858) 774-8687 | 2819 Sand Hill Rd Guyton, Georgia 31312 Map It | 2819 Sand Hill Rd Guyton, Georgia 31312 Map It | Hollingsworth Homes | |||||||||||||||||||
| 2025-27360806 | 06/17/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Submitted | 06/12/2026 | 06/12/2026 | Jeff Smith | New Construction | $400.00 | 1 | Propane furnace, or gas pack ($400.00) | Marathon | Eam5X36M17A1E | J253401653 | 06/12/2026 | img06172026_0006.pdf | $400.00 | Folger Gas | Stacy Mullinax | 4955 Appalachian Highway Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | Jeff Smith | (706) 455-2573 | Email hidden; Javascript is required. | 12 Dogwood Hills Way Morganton, Georgia 30560 Map It | 12 Dogwood Hills Way Morganton, Georgia 30560 Map It | n/a | ||||||||||||||||||
| 2025-11746785 | 06/17/2026 | Webb Brothers Propane, Inc | Kristy Gamble | (229) 382-0789 | Email hidden; Javascript is required. | Submitted | 06/17/2026 | 06/17/2026 | MICHAEL WEBB | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE160EP | WA.UA-001993 | 06/17/2026 | PREMIER-SERVICE.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 | PREMIER SERVICE | (229) 402-7264 | 109 MAGNOLIA DR TIFTON, Georgia 31794 Map It | 109 MAGNOLIA DR TIFTON, Georgia 31794 Map It | PREMIER-SERVICE1.pdf | ||||||||||||||||||
| 2025-11910014 | 06/18/2026 | HAROLDS PROPANE | HAROLD CAWTHON | (770) 775-4821 | Email hidden; Javascript is required. | Submitted | 06/01/2026 | 06/01/2026 | KEITH THOMPSON | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RHEEM | PROG40-32PRH62 | Q322500648 | 06/01/2026 | Scan_20260618.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 | BERNICE MCCLENDON | (770) 775-3254 | 884 DEAN PATRICK RD LOCUST GROVE, Georgia 30248 Map It | 884 DEAN PATRICK RD LOCUST GROVE, Georgia 30248 Map It | Scan_202606181.pdf | ||||||||||||||||||
| 2025-23903481 | 06/18/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Submitted | 06/17/2026 | 06/17/2026 | Kevin Smoot | New Construction | $450.00 | 3 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Takagi | T-KJR | 24006752 | 06/17/2026 | img20260618_14461521.pdf | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rheem | 42VSO-36PF | RHLP0107700074 | 06/17/2026 | img20260618_144615211.pdf | Cooktop ($50.00) | Whirlpool | WCG97U56H5200 | DA4811685 | 06/17/2026 | img20260618_144615212.pdf | $450.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Chris Casper | (678) 899-8982 | 890 Jones Wood Road Monroe, Georgia 30655 Map It | 890 Jones Wood Road Monroe, Georgia 30655 Map It | N/A | |||||||
| 2025-31820113 | 06/19/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Submitted | 06/16/2026 | 06/16/2026 | Cole Truett | Replacement or New Appliance | $50.00 | 1 | Replacement Installation | Cooktop ($50.00) | Whirlpool | WEG750H0HZ | RB2816742 | 06/16/2026 | LUKE-3029_1081_260619083926_001.pdf | $50.00 | 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 | Don Luke | (229) 415-0856 | Email hidden; Javascript is required. | 3029 Houser Way Hahira, Georgia 31632 Map It | 3029 Houser Way Hahira, Georgia 31632 Map It | LUKE-3029_1081_260619083926_0011.pdf | |||||||||||||||||
| 2025-17673565 | 06/19/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Submitted | 06/15/2026 | 06/15/2026 | Kevin Smoot | New Construction | $50.00 | 1 | Cooktop ($50.00) | GE | GGF600AV255 | LD018087Q | 06/15/2026 | img20260619_10174789.pdf | $50.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Courtney Harbin | (706) 435-7023 | 699 Sanford Lake Drive Nicholson, Georgia 30565 Map It | 699 Sanford Lake Drive Nicholson, Georgia 30565 Map It | N/A | |||||||||||||||||||
| 2025-76785183 | 06/19/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Submitted | 06/15/2026 | 06/15/2026 | Alex Cash | Replacement or New Appliance | $400.00 | 1 | Replacement Installation | Propane-Fueled Recirculating Water Heater ($400.00) | Rinnai | REP199iP | SHBD132697 | 06/15/2026 | img06192026_0011.pdf | $400.00 | Folger Gas | Stacy Mullinax | 4955 Appalachian Highway Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | William Bruce | (941) 700-7566 | Email hidden; Javascript is required. | 15112 21st Ave E Bradenton, Florida 34212 Map It | 119 Hidden Acres Mineral Bluff, Georgia 30559 Map It | img06192026_00111.pdf | |||||||||||||||||
| 2025-38520246 | 06/19/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Submitted | 06/17/2026 | 06/17/2026 | Alvin Wilcox | Replacement or New Appliance | $50.00 | 1 | Replacement Installation | Cooktop ($50.00) | Samsung | NX60A65155AAQ | BD14V7DAL100087N | 06/17/2026 | img06192026_0012.pdf | $50.00 | Folger Gas | Stacy Mullinax | 4955 Appalachian Highway Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | Tim Rolland | (770) 627-8644 | Email hidden; Javascript is required. | 123 Bob Pinson Street Ellijay, Georgia 30540 Map It | 4018 Carver Mill Rd Talking Rock, Georgia 30175 Map It | img06192026_00121.pdf | |||||||||||||||||
| 2025-88788574 | 06/19/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Submitted | 06/17/2026 | 06/17/2026 | Alvin Wilcox | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | REUVC2528FFUDUS | PECA084268 | 06/17/2026 | img06192026_0013.pdf | $200.00 | Folger Gas | Stacy Mullinax | 4955 Appalachian Highway Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | Ryan Beadnell | (704) 609-2243 | Email hidden; Javascript is required. | 311 N Cashes Valley Rd Blue Ridge, Georgia 30513 Map It | 311 N Cashes Valley Rd Blue Ridge, Georgia 30513 Map It | img06192026_00131.pdf | |||||||||||||||||
| 2025-90266462 | 06/19/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Submitted | 06/15/2026 | 06/15/2026 | Alvin Wilcox | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | REUVC2528FFUDUS | PGCA108565 | 06/15/2026 | img06192026_0014.pdf | $200.00 | Folger Gas | Stacy Mullinax | 4955 Appalachian Highway Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | Paul Gillen | (813) 781-9161 | 195 Central Way Blue Ridge, Georgia 30513 Map It | 195 Central Way Blue Ridge, Georgia 30513 Map It | img06192026_00141.pdf | ||||||||||||||||||
| 2025-17615138 | 06/19/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Submitted | 06/15/2026 | 06/15/2026 | Alvin Wilcox | Replacement or New Appliance | $50.00 | 1 | Conversion | Cooktop ($50.00) | Forno | FFSGS627730 | NV | 06/15/2026 | img06192026_0016.pdf | $50.00 | Folger Gas | Stacy Mullinax | 4955 Appalachian Highway Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | Ezra Shaner DBA Highland Home Construction | (706) 313-2640 | Email hidden; Javascript is required. | 143 Stonefly Ridge Blue Ridge, Georgia 30513 Map It | 190 Laurel Crossing Blue Ridge, Georgia 30513 Map It | img06192026_00161.pdf | |||||||||||||||||
| 2025-90467406 | 06/22/2026 | Conger LP Gas | Charlie Vining | (912) 501-3009 | Email hidden; Javascript is required. | Submitted | 06/19/2026 | 06/19/2026 | Charlie Vining | Replacement or New Appliance | $400.00 | 2 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | Re180EP | WC.UA-034445 | 06/19/2026 | Caroline-Rinnai-Rebate.pdf | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | Re180EP | WC.UA-034449 | 06/19/2026 | Caroline-Rinnai-Rebate1.pdf | $400.00 | Conger LP Gas | Charlie Vining | 217 Thompson Dr Douglas, Georgia 31533 Map It | Email hidden; Javascript is required. | (912) 501-3009 | Caroline Fender | (912) 501-3009 | 591 Inlet Harbor Dr Douglas, Georgia 31533 Map It | 591 Inlet Harbor Dr Douglas, Georgia 31533 Map It | Caroline-Rinnai-Rebate2.pdf | ||||||||||||
| 2025-58445499 | 06/24/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Submitted | 06/18/2026 | 06/18/2026 | Dillon Payne | New Construction | $400.00 | 1 | Propane furnace, or gas pack ($400.00) | Tempstar | EAM5X37M17A1E | JZ60311144 | 06/18/2026 | img06242026_0012.pdf | $400.00 | Folger Gas | Stacy Mullinax | 4955 Application Hwy Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | Robert Rogers | (706) 897-0962 | Email hidden; Javascript is required. | 138 Patrick Point Blairsville, Georgia 30512 Map It | 138 Patrick Point Blairsville, Georgia 30512 Map It | n/a | ||||||||||||||||||
| 2025-16491680 | 06/24/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Submitted | 06/18/2026 | 06/18/2026 | Alvin Wilcox | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnia | REUNB253o0FFUS | RJBA113214 | 06/18/2026 | img06242026_0013.pdf | $200.00 | Folger Gas | Stacy Mullinax | 4955 Application Hwy Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | Thomas Robinson | (615) 202-5381 | Email hidden; Javascript is required. | 4673 Matthews Road Ceder Hill, Tennessee 37032 Map It | 357 Black Ankle Creek Rd Cherry Log, Georgia 30522 Map It | img06242026_00131.pdf | |||||||||||||||||
| 2025-91822581 | 06/24/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Submitted | 06/19/2026 | 06/19/2026 | Alvin Wilcox | New Construction | $200.00 | 1 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnia | REUNBP3237F | TJBA210417 | 06/19/2026 | img06242026_0014.pdf | $200.00 | Folger Gas | Stacy Mullinax | 4955 Application Hwy Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | Craig Lumia | (239) 404-8948 | Email hidden; Javascript is required. | 4794 Europa Drive Naples, Florida 34105 Map It | 186 Logan Dr Mineral Bluff, Georgia 30559 Map It | N/A | ||||||||||||||||||
| 2025-72499432 | 06/24/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Submitted | 06/22/2026 | 06/22/2026 | Fernando Sordo | Replacement or New Appliance | $50.00 | 1 | Conversion | Cooktop ($50.00) | LG | LR6N63234 | 508MMYF04170 | 06/22/2026 | img06242026_0015.pdf | $50.00 | Folger Gas | Stacy Mullinax | 4955 Application Hwy Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | Kathyn Winland DBA Wingrove Stays LLC | (404) 840-5617 | Email hidden; Javascript is required. | 254 Aries Lane Blue Ridge, Georgia 30513 Map It | 254 Aries Lane Blue Ridge, Georgia 30513 Map It | img06242026_00151.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 |
