| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2025-81178061 | 02/03/2026 | Franklin Propane Gas, Inc. | Mike Franklin | (478) 552-6667 | Email hidden; Javascript is required. | Payment Sent | 02/03/2026 | 02/03/2026 | Jonathan Franklin | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180EP | TK.UA157487 | 02/03/2026 | Burgamy-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 | Robert Eric Burgamy | (478) 232-4298 | 278 Edwards Ford Road Tennille, Georgia 31089 Map It | 278 Edwards Ford Road Tennille, Georgia 31089 Map It | Burgamy-Rebate1.pdf | ||||||||||||||||||
| 2025-52363273 | 02/04/2026 | Conger LP gas Moultrie | Kyle Johnson | (229) 985-6942 | Email hidden; Javascript is required. | Payment Sent | 01/12/2026 | 01/12/2026 | Taylor Newsome | Replacement or New Appliance | $400.00 | 2 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RX199In | TE.BA-089304 | 01/12/2026 | 3348_260204145834_001.pdf | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RX199IN | TE.BA-089305 | 01/12/2026 | 3348_260204145834_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 | Laura Dell | (229) 921-6879 | Email hidden; Javascript is required. | 1309 Paul Murphy Rd Moultrie, Georgia 31788 Map It | 1309 Paul Murphy Rd Moultrie, Georgia 31788 Map It | 3348_260204145834_0012.pdf | |||||||||||
| 2025-56380593 | 02/05/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 01/29/2026 | 01/29/2026 | Matthew Ray | Replacement or New Appliance | $600.00 | 3 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RSC199eP | RE.BA-064828 | 01/29/2026 | THORNTON-4695_4793_260205132555_001.pdf | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RSC199eP | RH.BA-105577 | 01/29/2026 | THORNTON-4695_4793_260205132555_0011.pdf | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RSC199eP | RH.BA-105584 | 01/29/2026 | THORNTON-4695_4793_260205132555_0012.pdf | $600.00 | 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 | Rusty Thornton Construction | (229) 560-6424 | Email hidden; Javascript is required. | PO Box 3170 Valdosta, Georgia 31604 Map It | 4695 Barrett Coody Road Valdosta, Georgia 31601 Map It | THORNTON-4695_4793_260205132555_0013.pdf | |||||
| 2025-24380153 | 02/05/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 01/29/2026 | 01/29/2026 | Matthew Ray | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RSC199eP | RH.BA-105570 | 01/29/2026 | THORNTON-4695_4793_260205132555_0014.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 | Rusty Thornton Construction | (229) 560-6424 | Email hidden; Javascript is required. | PO Box 3170 Valdosta, Georgia 31604 Map It | 4695 Barrett Coody Road Valdosta, Georgia 31601 Map It | THORNTON-4695_4793_260205132555_0015.pdf | |||||||||||||||||
| 2025-76727170 | 02/05/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 01/28/2026 | 01/28/2026 | Cole Truett | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE160eP | TG.UA-098189 | 01/28/2026 | OWENS-367_4794_260205132639_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 | 367 Barryfield Circle Hahira, Georgia 31632 Map It | OWENS-367_4794_260205132639_0011.pdf | |||||||||||||||||
| 2025-99225722 | 02/05/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 01/28/2026 | 01/28/2026 | Cole Truett | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE160eP | TG.UA-098190 | 01/28/2026 | OWENS-363_4795_260205132707_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 | 363 Barryfield Circle Hahira, Georgia 31632 Map It | OWENS-363_4795_260205132707_0011.pdf | |||||||||||||||||
| 2025-53119522 | 02/05/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 01/28/2026 | 01/28/2026 | Cole Truett | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE160eP | TG.UA-098199 | 01/28/2026 | OWENS-216_4796_260205132735_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 | 216 Barryfield Hahira, Georgia 31632 Map It | OWENS-216_4796_260205132735_0011.pdf | |||||||||||||||||
| 2025-16963169 | 02/06/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 01/23/2026 | 01/23/2026 | Cole Truett | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180eP | TH.UA-114218 | 01/23/2026 | PREMIER-5220_4812_260206150836_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 | Premier Southern | (229) 263-1602 | Email hidden; Javascript is required. | 2410 Andover Drive Valdosta, Georgia 31602 Map It | 5220 Old Magnolia Valdosta, Georgia 31601 Map It | PREMIER-5220_4812_260206150836_0011.pdf | |||||||||||||||||
| 2025-20630718 | 02/09/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 02/03/2026 | 02/03/2026 | Cole Truett | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180eP | TH.UA-114227 | 02/03/2026 | SMITH-9112_4831_260209151029_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 | James Smith | (229) 412-0822 | Email hidden; Javascript is required. | 9112 Adel Hwy Morven, Georgia 31638 Map It | 9112 Adel Hwy Morven, Georgia 31638 Map It | SMITH-9112_4831_260209151029_0011.pdf | |||||||||||||||||
| 2025-56589547 | 02/10/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Processing | 01/21/2026 | 01/21/2026 | Kevin Smoot | New Construction | $50.00 | 1 | Cooktop ($50.00) | Frigidaire | GCFG3060BFD | VF53386227 | 01/21/2026 | img20260210_11272298.pdf | $50.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Nate Mclean | (706) 215-2921 | Email hidden; Javascript is required. | 129 Fox Hollow Way Athens, Georgia 30607 Map It | 129 Fox Hollow Way Athens, Georgia 30607 Map It | Nate Mclean | ||||||||||||||||||
| 2025-58561418 | 02/10/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Processing | 01/19/2026 | 01/19/2026 | Kevin Smoot | Replacement or New Appliance | $50.00 | 1 | New Installation | Cooktop ($50.00) | Bosch | NGM5655UC | 951100322 | 01/19/2026 | img20260210_12123632.pdf | $50.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Jonathan McCart | (706) 367-8782 | 701 Traditions Way Jefferson, Georgia 30549 Map It | 701 Traditions Way Jefferson, Georgia 30549 Map It | img20260210_121236321.pdf | ||||||||||||||||||
| 2025-67878160 | 02/11/2026 | Conger LP Gas | KAYLEA SMITH | (229) 469-4250 | Email hidden; Javascript is required. | Processing | 02/11/2026 | 02/11/2026 | Seth Weeks | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE160eP | TJ.UA-132942 | 02/11/2026 | WEAVER-3879_4852_260211111030_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 31602 Map It | 3879 Lu Lane Hahira, Georgia 31632 Map It | WEAVER-3879_4852_260211111030_0011.pdf | |||||||||||||||||
| 2025-24416183 | 02/11/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Processing | 02/04/2026 | 02/04/2026 | Kevin Smoot | New Construction | $50.00 | 1 | Cooktop ($50.00) | KitchenAid | KFGD988500 | DE3810662 | 02/04/2026 | img20260211_12021295.pdf | $50.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Joe Beasley | (470) 540-0742 | 1178 Pinnacle Drive Hoschton, Georgia 30548 Map It | 1178 Pinnacle Drive Hoschton, Georgia 30548 Map It | N/A | |||||||||||||||||||
| 2025-75189174 | 02/11/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Processing | 02/03/2026 | 02/03/2026 | Brent Walton | New Construction | $50.00 | 1 | Cooktop ($50.00) | Ferno | WHT24100061 | FFSGS6277 | 02/03/2026 | img20260211_12123018.pdf | $50.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Leo Manzo | (706) 367-8782 | 427 Swann Road Jefferson, Georgia 30549 Map It | 427 Swann Road Jefferson, Georgia 30549 Map It | N/A | |||||||||||||||||||
| 2025-63343066 | 02/11/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Processing | 02/05/2026 | 02/05/2026 | Kevin Smoot | Replacement or New Appliance | $250.00 | 2 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rheem | XP40T06EC3261 | A452503232 | 02/05/2026 | img20260211_12321741.pdf | Cooktop ($50.00) | Samsung | NX58J775055 | 068K7DDG402131M | 02/05/2026 | img20260211_123217411.pdf | $250.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Mark Hamrick | (706) 367-8782 | 387 Hunters Run Jefferson, Georgia 30549 Map It | 387 Hunters Run Jefferson, Georgia 30549 Map It | img20260211_123217412.pdf | ||||||||||||
| 2025-75317556 | 02/12/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Processing | 02/09/2026 | 02/09/2026 | Brent Walton | New Construction | $50.00 | 1 | Cooktop ($50.00) | ILVE | UPD406NMP | 2530014 | 02/09/2026 | img20260212_09594013.pdf | $50.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Brandy Cisco | (678) 776-2226 | 2185 Cabin Creek Road Nicholson, Georgia 30565 Map It | 2185 Cabin Creek Road Nicholson, Georgia 30565 Map It | N/A | |||||||||||||||||||
| 2025-11436424 | 02/12/2026 | Conger LP | Debora Simning | (229) 776-7336 | Email hidden; Javascript is required. | Processing | 01/20/2026 | 01/20/2026 | Levi Wilbanks | New Construction | $200.00 | 1 | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180ep | TF.UA-084782 | 01/20/2026 |  | $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. | 119 ELLI DR SYLVESTER, Georgia 31791 Map It | 1474 Warwick Ashburn Rd Warwick, Georgia 31796 Map It | CHAD MCDONALD CONSTRUCTION | ||||||||||||||||||
| 2025-60426766 | 02/12/2026 | Conger LP | Debora Simning | (229) 776-7336 | Email hidden; Javascript is required. | Processing | 02/04/2026 | 02/04/2026 | James Seabolt | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180ep | TF.UA-084770 | 02/04/2026 |  | $200.00 | Conger LP | Debora Simning | 306 S Main St Sylvester, Georgia 31791 Map It | Email hidden; Javascript is required. | (229) 776-7336 | Donna Sledge | (229) 848-2506 | Email hidden; Javascript is required. | 1026 Sledge Rd Ty Ty, Georgia 31795 Map It | 1026 Sledge Rd Ty Ty, Georgia 31795 Map It |  | |||||||||||||||||
| 2025-58203608 | 02/13/2026 | Webb Brothers Propane, Inc | Kristy Gamble | (229) 382-0789 | Email hidden; Javascript is required. | Processing | 02/12/2026 | 02/12/2026 | MICHAEL WEBB | Replacement or New Appliance | $200.00 | 1 | Conversion | Propane-Fueled Non-Recirculating Water Heater ($200.00) | RINNAI | RE180EP | TJ.UA-129999 | 02/12/2026 | DEE-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 | DEE PATEL | (470) 330-3700 | 31 CARPENTER RD N STE A TIFTON, Georgia 31793 Map It | 31 CARPENTER RD N STE A TIFTON, Georgia 31793 Map It | DEE-PATEL1.pdf | ||||||||||||||||||
| 2025-10882073 | 02/13/2026 | Conger LP gas Moultrie | Kyle Johnson | (229) 985-6942 | Email hidden; Javascript is required. | Processing | 02/05/2026 | 02/05/2026 | Conner Seabolt | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180EP | TF.UA-084775 | 02/05/2026 | 3422_260213160651_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 | Melinda Allegood | (229) 894-9030 | Email hidden; Javascript is required. | 323 S. Peachtree St Doerun, Georgia 31744 Map It | 323 S. Peachtree St Doerun, Georgia 31744 Map It | 3422_260213160651_0011.pdf | |||||||||||||||||
| 2025-44315077 | 02/13/2026 | Conger LP gas Moultrie | Kyle Johnson | (229) 985-6942 | Email hidden; Javascript is required. | Processing | 02/03/2026 | 02/03/2026 | Taylor Newsome | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE180EP | TF.UA-084777 | 02/03/2026 | 3424_260213171217_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 | Gage Helton | (229) 977-7582 | Email hidden; Javascript is required. | 2737 Fredonia Rd Thomasville, Georgia 31792 Map It | 2737 Fredonia Rd Thomasville, Georgia 31792 Map It | 3424_260213171217_0011.pdf | |||||||||||||||||
| 2025-20498134 | 02/16/2026 | Folger Gas | Heather Marchman | (706) 367-8782 | Email hidden; Javascript is required. | Processing | 02/13/2026 | 02/13/2026 | Owen Dills | New Construction | $50.00 | 1 | Cooktop ($50.00) | Whirlpool | WCGK5036P500 | DF0109383 | 02/13/2026 | img20260216_11002279.pdf | $50.00 | Folger Gas | Heather Marchman | 1950 Bill Wright Road Jefferson, Georgia 30549 Map It | Email hidden; Javascript is required. | (706) 367-8782 | Ed Mitchell | (803) 338-7295 | 3028 Mulberry Greens Lane Jefferson, Georgia 30549 Map It | 3028 Mulberry Greens Lane Jefferson, Georgia 30549 Map It | N/A | |||||||||||||||||||
| 2025-72128055 | 02/16/2026 | Conger LP gas Moultrie | Kyle Johnson | (229) 985-6942 | Email hidden; Javascript is required. | Processing | 01/30/2026 | 01/30/2026 | Dewayne Bruce | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE160EP | TD.UA-051302 | 01/30/2026 | 3426_260216114544_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 | Stewart Demott | (229) 873-9861 | Email hidden; Javascript is required. | 197 Harper Rd Moultrie, Georgia 31788 Map It | 197 Harper Rd Moultrie, Georgia 31788 Map It | 3426_260216114544_0011.pdf | |||||||||||||||||
| 2025-14873494 | 02/16/2026 | Conger LP | Debora Simning | (229) 776-7336 | Email hidden; Javascript is required. | Processing | 02/12/2026 | 02/12/2026 | James Seabolt | Replacement or New Appliance | $200.00 | 1 | New Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE199e | TF.UA-087268 | 02/12/2026 |  | $200.00 | Conger LP | Debora Simning | 306 S Main St Sylvester, Georgia 31791 Map It | Email hidden; Javascript is required. | (229) 776-7336 | John Acord | (229) 733-3085 | Email hidden; Javascript is required. | 127 Broad St Syl, Georgia 31791 Map It | 127 Broad St Syl, Georgia 31791 Map It | ||||||||||||||||||
| 2025-52239115 | 02/16/2026 | Franklin Propane Gas, Inc. | Mike Franklin | (478) 552-6667 | Email hidden; Javascript is required. | Processing | 02/16/2026 | 02/16/2026 | Jonathan Franklin | Replacement or New Appliance | $200.00 | 1 | Replacement Installation | Propane-Fueled Non-Recirculating Water Heater ($200.00) | Rinnai | RE160EP | TH.UA-113931 | 02/16/2026 | Van-Loenen-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 | Lorraine Van Loenen | (478) 364-6960 | 5468 Salter Road Bartow, Georgia 30413 Map It | 5468 Salter Road Bartow, Georgia 30413 Map It | Van-Loenen-rebate1.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 |
