| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2025-28905100 | 09/24/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Declined | 09/22/2026 | 09/22/2026 | Zach Adams | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE160eP | WC.UA-027979 | 09/22/2026 | JMC-804_1962_260924090159_001.pdf | $200.00 | Conger LP Gas | Richard McCranie | 2310 US Hwy 84 West Suite B Valdosta, Georgia 31601 Map It | Email hidden; Javascript is required. | (229) 469-4250 | JMC Construction | (229) 506-0375 | Email hidden; Javascript is required. | 78 Carters Mill Road Barney, Georgia 31625 Map It | 111 Corbett Lane Lake Park, Georgia 31636 Map It | JMC-CORBETT_1963_260924090232_001.pdf | |||||||||||||||||
| 2025-50996258 | 09/24/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Payment Sent | 09/22/2026 | 09/22/2026 | Zac Adams | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE160eP | WC.UA-027979 | 09/22/2026 | JMC-804_1962_260924090159_0011.pdf | $200.00 | Conger LP Gas | Richard McCranie | 2310 US Hwy 84 West Suite B Valdosta, Georgia 31601 Map It | Email hidden; Javascript is required. | (229) 469-4250 | JMC Construction | (229) 506-0375 | Email hidden; Javascript is required. | 78 Carters Mill Road Barney, Georgia 31625 Map It | 804 Tince Road Lake Park, Georgia 31636 Map It | JMC-804_1962_260924090159_0012.pdf | |||||||||||||||||
| 2025-23567694 | 09/24/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Payment Sent | 09/22/2026 | 09/22/2026 | Zach Adams | Replacement or New Appliance | $400.00 | 1 | Replacement Installation | Propane-Fueled Recirculating Water Heater ($400.00) | Rinnai | REP160eP | PL.UA-119984 | 09/22/2026 | JMC-CORBETT_1963_260924090232_0011.pdf | $400.00 | Conger LP Gas | Richard McCranie | 2310 US Hwy 84 West Suite B Valdosta, Georgia 31601 Map It | Email hidden; Javascript is required. | (229) 469-4250 | JMC Construction | (229) 506-0375 | Email hidden; Javascript is required. | 78 Carters Mill Road Barney, Georgia 31625 Map It | 111 Corbett Lane Lake Park, Georgia 31636 Map It | JMC-CORBETT_1963_260924090232_0012.pdf | |||||||||||||||||
| 2025-62709294 | 09/24/2026 | PARTNERS PROPANE OF GA INC. | AMANDA ALBRITTON | (478) 862-4644 | Email hidden; Javascript is required. | Payment Sent | 09/24/2026 | 09/24/2026 | TYLER ROBINSON | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RHEEM | PROG40P | Q042631939 | 09/24/2026 | Document_20260918_0001.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 | VIRGINIA HAMILTON | (229) 938-6930 | 17 OAK CREST RD ELLAVILLE, Georgia 31806 Map It | 17 OAK CREST RD ELLAVILLE, Georgia 31806 Map It | Document_20260918_00011.pdf | ||||||||||||||||||
| 2025-72442585 | 09/25/2026 | Conger LP GAS | christina Duncan | (912) 537-8722 | Email hidden; Javascript is required. | Payment Sent | 08/26/2026 | 08/26/2026 | Jonathan Mauldin | New Construction | $200.00 | 1 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180ep | WD.UA-035850 | 08/26/2026 | TILLMAN.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 | Brad Tilman | (912) 278-3820 | 211 Sumter St Lyons, Georgia 30436 Map It | PO Box 257 Alston, Georgia 30412 Map It | Brad Tilman | |||||||||||||||||||
| 2025-50638513 | 09/25/2026 | Conger LP GAS | christina Duncan | (912) 537-8722 | Email hidden; Javascript is required. | Payment Sent | 08/27/2026 | 08/27/2026 | Jackson Hartley | New Construction | $200.00 | 1 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180ep | WG.UA-077575 | 08/27/2026 | WILCOX_20260925_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 | Talia Wilcox | (912) 314-4738 | 65 Hester Rd Hazelhurst, Georgia 31539 Map It | 65 Hester Rd Hazelhurst, Georgia 31539 Map It | Mckenzie Builders Greg | |||||||||||||||||||
| 2025-91738427 | 09/25/2026 | Conger LP GAS | christina Duncan | (912) 537-8722 | Email hidden; Javascript is required. | Payment Sent | 09/23/2026 | 09/23/2026 | Jackson Hartley | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE199ep | TJ.UA-142739 | 09/23/2026 | EATON_20260925_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 | Brenden Eaton | (630) 854-7678 | 2377 Center Dr Vidalia, Georgia 30474 Map It | 2377 Center Dr Vidalia, Georgia 30474 Map It | EATON_20260925_00011.pdf | ||||||||||||||||||
| 2025-75380055 | 09/25/2026 | Conger LP GAS | christina Duncan | (912) 537-8722 | Email hidden; Javascript is required. | Payment Sent | 09/22/2026 | 09/22/2026 | Jonathan Mauldin | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE199ep | WA.UA-012225 | 09/22/2026 | ROBINSON_20260925_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 | Ashley Robinson | (478) 919-5175 | 61 N Prong Rd Swainsboro, Georgia 30401 Map It | 61 N Prong Rd Swainsboro, Georgia 30401 Map It | ROBINSON_20260925_00011.pdf | ||||||||||||||||||
| 2025-54387568 | 09/25/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Payment Sent | 09/22/2026 | 09/22/2026 | Fernando Sordo | New Construction | $400.00 | 1 | Propane furnace, or gas pack ($400.00) | Runthru | 5MXCC9AC6HCAA | 250830161NA | 09/22/2026 | img09252026_0003.pdf | $400.00 | Folger Gas | Stacy Mullinax | 4955 Appalachian Hwy Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | Urvin Gandhi | (773) 908-4882 | Email hidden; Javascript is required. | 115 Whisperwood Trail Blairsville, Georgia 30512 Map It | 115 Whisperwood Trail Blairsville, Georgia 30512 Map It | n/a | ||||||||||||||||||
| 2025-14506453 | 09/25/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Payment Sent | 09/23/2026 | 09/23/2026 | Alvin Wilcox | New Construction | $600.00 | 2 | Propane furnace, or gas pack ($400.00) | Caries | EAM5X37M17A1E | 5253204707 | 09/23/2026 | img09252026_0010.pdf | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | REUNBP32371FFUSN | TSBA219310 | 09/23/2026 | img09252026_00101.pdf | $600.00 | Folger Gas | Stacy Mullinax | 4955 Appalachian Highway Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | Seth Loeb | (706) 455-8211 | Email hidden; Javascript is required. | 85 Sunrock Mountain Road Blue Ridge, Georgia 30513 Map It | 340 Cardinal Ln Blue Ridge, Georgia 30513 Map It | n/a | ||||||||||||
| 2025-11727600 | 09/25/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Payment Sent | 09/22/2026 | 09/22/2026 | Cole Truett | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE199eP | WE.UA-056930 | 09/22/2026 | JMC-3904_1990_260925142949_001.pdf | $200.00 | Conger LP Gas | Richard McCranie | 2310 US Hwy 84 West Suite B Valdosta, Georgia 31601 Map It | Email hidden; Javascript is required. | (229) 469-4250 | JMC Construction | (229) 506-0375 | Email hidden; Javascript is required. | 78 Carters Mill Road Barney, Georgia 31625 Map It | 3904 MJ Taylor Road Adel, Georgia 31620 Map It | JMC-3904_1990_260925142949_0011.pdf | |||||||||||||||||
| 2025-17151759 | 09/25/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Payment Sent | 09/23/2026 | 09/23/2026 | Brandon Payne | Replacement or New Appliance | $50.00 | 1 | Conversion | Cooktop ($50.00) | Kitchen Aid | RCGCC06J5502 | DE0902981 | 09/23/2026 | img09252026_0011.pdf | $50.00 | Folger Gas | Stacy Mullinax | 4955 Appalachian Highway Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | Renee Lake | (706) 889-8553 | Email hidden; Javascript is required. | 156 Overlake Ct. Morganton, Georgia 30560 Map It | 156 Overlake Ct. Morganton, Georgia 30560 Map It | img09252026_00111.pdf | |||||||||||||||||
| 2025-45662778 | 09/25/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Payment Sent | 09/21/2026 | 09/21/2026 | Frank Crosier | Replacement or New Appliance | $50.00 | 1 | Conversion | Cooktop ($50.00) | Kitchenaid | KS655305P30 | RF0718249 | 09/21/2026 | img09252026_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 | Frank Crosier | (812) 972-2030 | Email hidden; Javascript is required. | 100 Redridge Rd Morganton, Georgia 30560 Map It | 100 Redridge Rd Morganton, Georgia 30560 Map It | img09252026_00121.pdf | |||||||||||||||||
| 2025-25842603 | 09/25/2026 | Folger Gas | Stacy Mullinax | (706) 632-7606 | Email hidden; Javascript is required. | Payment Sent | 09/21/2026 | 09/21/2026 | David Holland | New Construction | $250.00 | 2 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RX161 | TABA015952 | 09/21/2026 | img09252026_0013.pdf | Cooktop ($50.00) | Kitchenaid | KFDD9485510 | DF0802736 | 09/21/2026 | img09252026_00131.pdf | $250.00 | Folger Gas | Stacy Mullinax | 4955 Appalachian Highway Blue Ridge, Georgia 30513 Map It | Email hidden; Javascript is required. | (706) 632-7606 | David Holland | (912) 266-1846 | Email hidden; Javascript is required. | 125 Old Bend Rd Blue Ridge, Georgia 30513 Map It | 125 Old Bend Rd Blue Ridge, Georgia 30513 Map It | n/a | ||||||||||||
| 2025-79429198 | 09/25/2026 | Conger LP Gas | Darby Greene | (912) 208-8000 | Email hidden; Javascript is required. | Processing | 09/01/2026 | 09/01/2026 | TERRY WHITE | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNIA | RE180EP | WC.UA-023188 | 09/01/2026 | $200.00 | Conger LP Gas | Darby Greene | 600 Main St Ste 102 Blackshear, Georgia 31516 Map It | Email hidden; Javascript is required. | (912) 208-8000 | WILLIAM JEFFERS | (912) 288-2613 | Email hidden; Javascript is required. | 6725 Thorn Bird Rd. Millwood, Georgia 31552 Map It | 6725 Thorn Bird Rd. Millwood, Georgia 31552 Map It | |||||||||||||||||||
| 2025-29543729 | 09/28/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Processing | 09/25/2026 | 09/25/2026 | Owen Dills | New Construction | $250.00 | 2 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | A. O. Smith | G6-53032PUR-40 | 2045121798122 | 09/25/2026 | img20260928_10550539.pdf | Cooktop ($50.00) | G.E. | RGB5300DM2BB | 2R147498R | 09/25/2026 | img20260928_105505391.pdf | $250.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Al Adkins | (706) 367-4763 | 706 Ingram Hancock Road Commerce, Georgia 30530 Map It | 706 Ingram Hancock Road Commerce, Georgia 30530 Map It | N/A | |||||||||||||
| 2025-96139369 | 09/28/2026 | Conger LP Gas | Darby Greene | (912) 208-8000 | Email hidden; Javascript is required. | Updated | 09/01/2026 | 09/01/2026 | MICHEAL STEWART | Replacement or New Appliance | $400.00 | 1 | New Installation | Propane furnace, or gas pack ($400.00) | RINNIA | RX199I | TD.BA-076993 | 09/01/2026 | $400.00 | Conger LP Gas | Darby Greene | 600 Main St Ste 102 Blackshear, Georgia 31516 Map It | Email hidden; Javascript is required. | (912) 208-8000 | JACOB JEFFORDS | (912) 614-0054 | Email hidden; Javascript is required. | 4791 PINE VIEW CHURCH RD waycross, Georgia 31501 Map It | 4791 PINE VIEW CHURCH RD waycross, Georgia 31501 Map It | 1254_260928004043_0011.pdf | ||||||||||||||||||
| 2025-64454292 | 09/28/2026 | Conger LP Gas | Darby Greene | (912) 208-8000 | Email hidden; Javascript is required. | Updated | 09/01/2026 | 05/01/2026 | TERRY WHITE | Replacement or New Appliance | $400.00 | 1 | New Installation | Propane furnace, or gas pack ($400.00) | RINNAI | RE180EP | TJ.UA-134968 | 09/01/2026 | $400.00 | Conger LP Gas | Darby Greene | 600 Main St Ste 102 Blackshear, Georgia 31516 Map It | Email hidden; Javascript is required. | (912) 208-8000 | GARY TIPPINS | (912) 717-0694 | Email hidden; Javascript is required. | 254 BILLY THRIFT RD FOLKSTON, Georgia 31537 Map It | 254 BILLY THRIFT RD FOLKSTON, Georgia 31537 Map It | 1255_260928010157_0011.pdf | ||||||||||||||||||
| 2025-38210338 | 09/28/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 09/24/2026 | 09/24/2026 | Cole Truett | Replacement or New Appliance | $400.00 | 1 | Replacement Installation | Propane-Fueled Recirculating Water Heater ($400.00) | Rinnai | REP160eP | PL.UA-119994 | 09/24/2026 | JMC-6211_2006_260928145928_001.pdf | $400.00 | Conger LP Gas | Richard McCranie | 2310 US Hwy 84 West Valdosta, Georgia 31601 Map It | Email hidden; Javascript is required. | (229) 469-4250 | JMC Construction | (229) 506-0375 | Email hidden; Javascript is required. | 78 Carters Mill Road Barney, Georgia 31625 Map It | 6211 Hardee Road Hahira, Georgia 31632 Map It | JMC-6211_2006_260928145928_0011.pdf | |||||||||||||||||
| 2025-15921282 | 09/28/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 09/25/2026 | 09/25/2026 | Matthew Ray | Replacement or New Appliance | $400.00 | 1 | Replacement Installation | Propane-Fueled Recirculating Water Heater ($400.00) | Rinnai | REP160eP | WJ.UA-106832 | 09/25/2026 | OWENS-5065_2008_260928150049_001.pdf | $400.00 | Conger LP Gas | Richard McCranie | 2310 US Hwy 84 West 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 | 5065 Hamilton Green Valdosta, Georgia 31601 Map It | OWENS-5065_2008_260928150049_0011.pdf | |||||||||||||||||
| 2025-82521283 | 09/28/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 09/25/2026 | 09/25/2026 | Matthew Ray | Replacement or New Appliance | $400.00 | 1 | Replacement Installation | Propane-Fueled Recirculating Water Heater ($400.00) | Rinnai | REP160eP | WJ.UA-106833 | 09/25/2026 | OWENS-5093_2007_260928150018_001.pdf | $400.00 | Conger LP Gas | Richard McCranie | 2310 US Hwy 84 West 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 | 5093 Hamilton Green Valdosta, Georgia 31601 Map It | OWENS-5093_2007_260928150018_0011.pdf | |||||||||||||||||
| 2025-53419430 | 09/29/2026 | Sikes Propane Inc | Daniel Sikes Jr | (912) 367-1151 | Email hidden; Javascript is required. | Processing | 09/21/2026 | 09/21/2026 | DANIEL SIKES | Replacement or New Appliance | $50.00 | 1 | Replacement Installation | Cooktop ($50.00) | SAMSUNG | NSG6D687005RAA | OCN17DAX300753N | 09/21/2026 | HPSCAN_20260929122735453_2026-09-29_122823261-1-compressed.pdf | $50.00 | SIKES PROPANE INC | SIKES PROPANE | 1488 GOLDEN ISLES WEST BAXLEY, Georgia 31513 Map It | Email hidden; Javascript is required. | (912) 367-1151 | Maria Rodriguez | (912) 553-1544 | 7 Kemp Rd Baxley, Georgia 31513 Map It | 7 Kemp Rd Baxley, Georgia 31513 Map It | HPSCAN_20260929122735453_2026-09-29_122823261-1-compressed1.pdf | ||||||||||||||||||
| 2025-45421401 | 09/29/2026 | Conger LP Gas | Darby Greene | (912) 208-8000 | Email hidden; Javascript is required. | Updated | 09/27/2026 | 04/29/2026 | TERRY WHITE | Replacement or New Appliance | $400.00 | 1 | New Installation | Propane-Fueled Recirculating Water Heater ($400.00) | RINNIA | RXP199 | TG.BA-170681 | 09/27/2026 | $400.00 | Conger LP Gas | Darby Greene | 600 Main St Ste 102 Blackshear, Georgia 31516 Map It | Email hidden; Javascript is required. | (912) 208-8000 | SECOND BAPTIST CHURCH | (912) 283-0436 | Email hidden; Javascript is required. | 408 RILEY RD. WAYCROSS, Georgia 31503 Map It | 408 RILEY RD. WAYCROSS, Georgia 31503 Map It | 1257_260928210526_0011.pdf | ||||||||||||||||||
| 2025-94507001 | 09/29/2026 | Webb Brothers Propane, Inc | Kristy Gamble | (229) 382-0789 | Email hidden; Javascript is required. | Processing | 09/29/2026 | 09/29/2026 | ROBERT COTHREN | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180EP | WG.UA-088683 | 09/29/2026 | CARLA-DODSON.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 | CARLA DODSON | (404) 797-5863 | 27 JENNY DR 27 JENNY DR TIFTON, Georgia 31793 Map It | 27 JENNY DR 27 JENNY DR TIFTON, Georgia 31793 Map It | CARLA-DODSON1.pdf | ||||||||||||||||||
| 2025-11745937 | 09/29/2026 | Barfield Gas Company, Inc. | Michael Davis | (229) 896-4828 | Email hidden; Javascript is required. | Processing | 09/17/2026 | 09/17/2026 | Caleb Harnage | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE140eP | WG.UA-077831 | 09/17/2026 | REBATE-W.KELLEY-58260.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 | WILL KELLEY | (229) 560-0833 | 256 SUSIE MCCRANIE RD SPARKS, Georgia 31647 Map It | 256 SUSIE MCCRANIE RD SPARKS, Georgia 31647 Map It | REBATE-W.KELLEY-582601.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 |
