| Invoice # | Recipient Name | Customer / Recipient Email | Mailing Address | Installation Address | Company Name | Company Phone | Company Email | Application Age | Rebate Status | Rebate Expiration | Safety Inspection Date | Purchase/Invoice Date | Type of Installation | Were you affected by hurricane Helene? | What county do you live in? | How many rebates would you like to claim? | Installation Type | Rebate #1 | Appliance Type | Appliance Type | Brand | Model # | Serial Number | Installation Date | Upload Receipt | Upload Receipt | Rebate #2 | Appliance Type | Appliance Type | Brand | Model # | Serial Number | Installation Date | Upload Receipt | Upload Receipt | Rebate #3 | Appliance Type | Appliance Type | Brand | Model # | Serial Number | Installation Date | Upload Receipt | Upload Receipt | Rebate #4 | Appliance Type | Appliance Type | Model # | Brand | Serial Number | Installation Date | Upload Receipt | Upload Receipt | Rebate #5 | Appliance Type | Appliance Type | Model # | Brand | Serial Number | Installation Date | Upload Receipt | Upload Receipt | Total | Customer / Recipient Name | Customer / Recipient Phone Number | Customer / Recipient Email | Customer / Recipient Address | Customer / Recipient Installation Address | Required Materials | Upload Proof of Purchase: | Name of Builder/Contractor | Upload Spec Sheet for Manufactured Home |
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| 2024-18822637 | MARIA KINCAID | 145 Papoose Drive Louisburg, North Carolina 27549 Map It | 145 Papoose Drive Louisburg, North Carolina 27549 Map It | Williams Fuel- Superior Plus Propane | (252) 823-5126 | Email hidden; Javascript is required. | 7 | Payment Sent | 09/24/2024 | 09/12/2024 | Replacement or New Appliance | 1 | Propane to Propane | Room Heater ($150.00) | EMPIRE | DV25SGLPG | 234562874 | 09/24/2024 |  | $150.00 | MARIA KINCAID | (919) 339-8879 | 145 Papoose Drive Louisburg, North Carolina 27549 Map It | 147 Papoose Drive Louisburg, North Carolina 27549 Map It | The following materials are required to complete your application:
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| 2024-14406313 | MEREDITH ESKRIDGE | Email hidden; Javascript is required. | PO BOX 1834 424 YADKIN RUN LN SOUTHERN PINES, North Carolina 28388 Map It | PO BOX 1834 424 YADKIN RUN LN SOUTHERN PINES, North Carolina 28388 Map It | McNeill Oil and Propane | (910) 944-2329 | Email hidden; Javascript is required. | 11 | Payment Sent | 09/20/2024 | 08/01/2024 | Replacement or New Appliance | 2 | Replacement Installation | RINNAI | RE199i | RJ-US-127585 | 09/20/2024 | COOLTOP.pdf | KITCHEN AIDE | KSDB900ESS | RD2010953 | 09/20/2024 | TANKLESS.pdf | $0.00 | MEREDITH ESKRIDGE | (919) 280-3947 | Email hidden; Javascript is required. | PO BOX 1834 424 YADKIN RUN LN SOUTHERN PINES, North Carolina 28388 Map It | PO BOX 1834 424 YADKIN RUN LN SOUTHERN PINES, North Carolina 28388 Map It | The following materials are required to complete your application:
| RECEIPTS.pdf | ||||||||||||||||||||||||||||||||||||||||
| 2024-53425625 | JEFF ROSE | Email hidden; Javascript is required. | 855 SELAH CHURCH RD GOLSBORO, North Carolina 27530 Map It | 855 SELAH CHURCH RD GOLSBORO, North Carolina 27530 Map It | Parker Gas company | (910) 323-8283 | Email hidden; Javascript is required. | 21 | Payment Sent | 09/11/2024 | 09/11/2024 | Replacement or New Appliance | 1 | Replacement Installation | RHEMM | PROG40-32PRH62 | Q132418351 | 09/11/2024 | 4105.pdf | $0.00 | JEFF ROSE | (919) 922-0714 | Email hidden; Javascript is required. | 855 SELAH CHURCH RD GOLSBORO, North Carolina 27530 Map It | 855 SELAH CHURCH RD GOLSBORO, North Carolina 27530 Map It | The following materials are required to complete your application:
| 41051.pdf | |||||||||||||||||||||||||||||||||||||||||||||
| 2024-51606929 | HENRY TURLINGTON | 991 BONNETTSVILLE RD SALEMBURG, North Carolina 28385 Map It | 991 BONNETTSVILLE RD SALEMBURG, North Carolina 28385 Map It | Parker Gas company | (910) 323-8283 | Email hidden; Javascript is required. | 5 | Payment Sent | 09/27/2024 | 09/27/2024 | Replacement or New Appliance | 1 | Conversion | RHEEM | PROG40-32PRH62 | Q13418352 | 09/27/2024 | 15161-TURLINGTON.pdf | $0.00 | HENRY TURLINGTON | (919) 624-0299 | 991 BONNETTSVILLE RD SALEMBURG, North Carolina 28385 Map It | 1600 QUAKER RIDGE POINT RALEIGH, North Carolina 27615 Map It | The following materials are required to complete your application:
| 15161-TURLINGTON1.pdf | |||||||||||||||||||||||||||||||||||||||||||||||
| 2024-19774178 | HARLESLY & MELISSA MELVIN | Email hidden; Javascript is required. | 127 BAYSHORE DR PARKTON, North Carolina 28371 Map It | 127 BAYSHORE DR PARKTON, North Carolina 28371 Map It | Parker Gas company | (910) 323-8283 | Email hidden; Javascript is required. | 6 | Payment Sent | 09/26/2024 | 09/26/2024 | Replacement or New Appliance | 1 | Replacement Installation | RINNAI | REP199ELP | PH.UA-070641 | 09/26/2024 | 43922.pdf | $0.00 | HARLESLY & MELISSA MELVIN | (910) 864-3191 | Email hidden; Javascript is required. | 127 BAYSHORE DR PARKTON, North Carolina 28371 Map It | 127 BAYSHORE DR PARKTON, North Carolina 28371 Map It | The following materials are required to complete your application:
| 439221.pdf | |||||||||||||||||||||||||||||||||||||||||||||
| 2024-98661455 | RONALD HUDSON | 8584 US 701 S NEWTON GROVE, North Carolina 28366 Map It | 8584 US 701 S NEWTON GROVE, North Carolina 28366 Map It | Parker Gas company | (910) 323-8283 | Email hidden; Javascript is required. | 6 | Payment Sent | 09/27/2024 | 09/27/2024 | Replacement or New Appliance | 1 | Replacement Installation | RINNAI | RE180E | SG.UA-100835 | 09/27/2024 | 2248.pdf | $0.00 | RONALD HUDSON | (919) 820-0801 | 8584 US 701 S NEWTON GROVE, North Carolina 28366 Map It | 8584 US 701 S NEWTON GROVE, North Carolina 28366 Map It | The following materials are required to complete your application:
| 22481.pdf | |||||||||||||||||||||||||||||||||||||||||||||||
| 2024-17285285 | JASON & DENEICE ELMORE | Email hidden; Javascript is required. | 88 EASON ELMORE RD DUNN, North Carolina 28334 Map It | 88 EASON ELMORE RD DUNN, North Carolina 28334 Map It | Parker Gas company | (910) 323-8283 | Email hidden; Javascript is required. | 13 | Payment Sent | 09/20/2024 | 09/20/2024 | Replacement or New Appliance | 1 | Replacement Installation | RINNAI | RE199E | SG.UA-093975 | 09/20/2024 | 3004621.pdf | $0.00 | JASON & DENEICE ELMORE | (910) 891-8931 | Email hidden; Javascript is required. | 88 EASON ELMORE RD DUNN, North Carolina 28334 Map It | 88 EASON ELMORE RD DUNN, North Carolina 28334 Map It | The following materials are required to complete your application:
| 30046211.pdf | |||||||||||||||||||||||||||||||||||||||||||||
| 2024-93844936 | PAT BOWDEN | 11011 HOBBTON HWY CLINTON, North Carolina 28328 Map It | 11011 HOBBTON HWY CLINTON, North Carolina 28328 Map It | Parker Gas company | (910) 323-8283 | Email hidden; Javascript is required. | 2 | Payment Sent | 10/01/2024 | 10/01/2024 | Replacement or New Appliance | 1 | Replacement Installation | RINNAI | RE160E | SC.UA-040900 | 10/01/2024 | 1145.PDF | $0.00 | PAT BOWDEN | (910) 596-7156 | 11011 HOBBTON HWY CLINTON, North Carolina 28328 Map It | 11011 HOBBTON HWY CLINTON, North Carolina 28328 Map It | The following materials are required to complete your application:
| 11451.PDF | |||||||||||||||||||||||||||||||||||||||||||||||
| 2024-18973973 | COUNTRY SQUIRE | Email hidden; Javascript is required. | 748 NC 24 AND 50 HWY WARSAW, North Carolina 28398 Map It | 748 NC 24 AND 50 HWY WARSAW, North Carolina 28398 Map It | Parker Gas company | (910) 323-8283 | Email hidden; Javascript is required. | 9 | Payment Sent | 09/24/2024 | 09/24/2024 | Replacement or New Appliance | 1 | Replacement Installation | RINNAI | RE180E | SG.UA-100833 | 09/24/2024 | doc00204820241002120223.pdf | $0.00 | COUNTRY SQUIRE | (910) 296-1727 | Email hidden; Javascript is required. | 748 NC 24 AND 50 HWY WARSAW, North Carolina 28398 Map It | 748 NC 24 AND 50 HWY WARSAW, North Carolina 28398 Map It | The following materials are required to complete your application:
| doc002048202410021202231.pdf | |||||||||||||||||||||||||||||||||||||||||||||
| 2024-19021107 | MOUNT OLIVE PRESBYTERIAN CHURCH | Email hidden; Javascript is required. | 105 N BREAZEALE AVE MT OLIVE, North Carolina 28365 Map It | 105 N BREAZEALE AVE MT OLIVE, North Carolina 28365 Map It | Parker Gas company | (910) 323-8283 | Email hidden; Javascript is required. | 6 | Payment Sent | 09/27/2024 | 09/27/2024 | Replacement or New Appliance | 1 | Replacement Installation | RINNAI | RE160E | SH.UA-111626 | 09/27/2024 | doc00204920241002120237.pdf | $0.00 | MOUNT OLIVE PRESBYTERIAN CHURCH | (910) 658-2044 | Email hidden; Javascript is required. | 105 N BREAZEALE AVE MT OLIVE, North Carolina 28365 Map It | PO BOX 158 MT OLIVE, North Carolina 28365 Map It | The following materials are required to complete your application:
| doc002049202410021202371.pdf | |||||||||||||||||||||||||||||||||||||||||||||
| 2024-56160674 | OWEN WHITE | 240 CHALLENGE CLUB DR CLINTON, North Carolina 28328 Map It | 240 CHALLENGE CLUB DR CLINTON, North Carolina 28328 Map It | Parker Gas company | (910) 323-8283 | Email hidden; Javascript is required. | 9 | Payment Sent | 09/24/2024 | 09/24/2024 | Replacement or New Appliance | 1 | Replacement Installation | RINNAI | RE199E | SA.UA-010468 | 09/24/2024 | doc00205020241002120252.pdf | $0.00 | OWEN WHITE | (910) 305-0277 | 240 CHALLENGE CLUB DR CLINTON, North Carolina 28328 Map It | 542 WIMBLETON DR RALEIGH, North Carolina 27609 Map It | The following materials are required to complete your application:
| doc002050202410021202521.pdf | |||||||||||||||||||||||||||||||||||||||||||||||
| 2024-34318297 | JOSHUA WOODS | Email hidden; Javascript is required. | 64 DATTON CT. FUQUAY-VARINA, North Carolina 27526 Map It | 64 DATTON CT. FUQUAY-VARINA, North Carolina 27526 Map It | K.B. Johnson Oil & Gas Co. | (919) 552-8474 | Email hidden; Javascript is required. | 3 | Payment Sent | 09/30/2024 | 09/12/2024 | New Construction | 2 | NAVIEN | NPE180S2 | 2080Y2412999137 | 09/30/2024 | KITCHEN AID | KCGS556ESS06 | DD2409969 | 09/12/2024 | $0.00 | JOSHUA WOODS | (919) 475-4977 | Email hidden; Javascript is required. | 64 DATTON CT. FUQUAY-VARINA, North Carolina 27526 Map It | 64 DATTON CT. FUQUAY-VARINA, North Carolina 27526 Map It | The following materials are required to complete your application:
| PORTER BUILT HOMES | |||||||||||||||||||||||||||||||||||||||||||
| 2024-47493899 | Sujatha Annamreddy | Email hidden; Javascript is required. | 14217 Pine Perch Street Cary, North Carolina 27519 Map It | 14217 Pine Perch Street Cary, North Carolina 27519 Map It | L.G. Jordan Oil Co., Inc. | (919) 362-8388 | Email hidden; Javascript is required. | 1 | Payment Sent | 10/02/2024 | 10/02/2024 | New Construction | 1 | Whirpool | WCGK5036 | DD2608616 | 10/02/2024 | new-construction.pdf | $0.00 | Sujatha Annamreddy | (984) 789-8440 | Email hidden; Javascript is required. | 14217 Pine Perch Street Cary, North Carolina 27519 Map It | 143 Yellow River Way Garner, North Carolina 27529 Map It | The following materials are required to complete your application:
| New Home Inc. | ||||||||||||||||||||||||||||||||||||||||||||||
| 2024-35157204 | JOHNATHAN NICHOLS | Email hidden; Javascript is required. | 10755 HWY 16N MILLERS CREEK, North Carolina 28651 Map It | 10755 HWY 16N MILLERS CREEK, North Carolina 28651 Map It | G&B ENERGY | (336) 973-2411 | Email hidden; Javascript is required. | 9 | Payment Sent | 09/25/2024 | 09/25/2024 | Replacement or New Appliance | 1 | Replacement Installation | RINNAI | RL75IP | PF.CA-084877 | 09/25/2024 | JOHNATHAN-NICHOLS-WATER-HEATER-PURCHASE.pdf | $0.00 | JOHNATHAN NICHOLS | (336) 667-8991 | Email hidden; Javascript is required. | 10755 HWY 16N MILLERS CREEK, North Carolina 28651 Map It | 10755 HWY 16N MILLERS CREEK, North Carolina 28651 Map It | The following materials are required to complete your application:
| JOHNATHAN-NICHOLS-WATER-HEATER-PURCHASE1.pdf | |||||||||||||||||||||||||||||||||||||||||||||
| 2024-31899383 | Tony Pearson | Email hidden; Javascript is required. | Tony Pearson 236 Old School House Rd Moravian Falls, North Carolina 28654 Map It | Tony Pearson 236 Old School House Rd Moravian Falls, North Carolina 28654 Map It | G&B ENERGY | (336) 973-2411 | Email hidden; Javascript is required. | 8 | Payment Sent | 09/26/2024 | 09/26/2024 | Replacement or New Appliance | 1 | Replacement Installation | KOZY HEAT | LXL22L | 22LX220034538 | 09/26/2024 | TONY-PEARSON-PURCHASE-DV-STOVE.pdf | $0.00 | Tony Pearson | (336) 902-0225 | Email hidden; Javascript is required. | Tony Pearson 236 Old School House Rd Moravian Falls, North Carolina 28654 Map It | Tony Pearson 236 Old School House Rd Moravian Falls, North Carolina 28654 Map It | The following materials are required to complete your application:
| TONY-PEARSON-PURCHASE-DV-STOVE1.pdf | |||||||||||||||||||||||||||||||||||||||||||||
| 2024-14108090 | Jonathan Alexander | Email hidden; Javascript is required. | 27 Salem Village Dr Fuquay Varina, North Carolina 27526 Map It | 27 Salem Village Dr Fuquay Varina, North Carolina 27526 Map It | L.G. Jordan Oil Co., Inc. | (919) 362-8388 | Email hidden; Javascript is required. | 1 | Payment Sent | 10/03/2024 | 10/03/2024 | New Construction | 1 | Frigidaire | GCCG3648AS | 1F40290229 | 10/03/2024 | new-construction1.pdf | $0.00 | Jonathan Alexander | (919) 886-2779 | Email hidden; Javascript is required. | 27 Salem Village Dr Fuquay Varina, North Carolina 27526 Map It | 27 Salem Village Dr Fuquay Varina, North Carolina 27526 Map It | The following materials are required to complete your application:
| New Home Inc. | ||||||||||||||||||||||||||||||||||||||||||||||
| 2024-15399913 | Terry Benton | 2961 Old Hiway 60 Ronda, North Carolina 28670 Map It | 2961 Old Hiway 60 Ronda, North Carolina 28670 Map It | G & B Energy | (336) 835-3607 | Email hidden; Javascript is required. | 4 | Payment Sent | 10/01/2024 | 10/01/2024 | Replacement or New Appliance | 1 | Replacement Installation | Bradfordwhite | RG1PV40S6X19 | ZM52574677 | 10/01/2024 | BRNB42200A94A58_001334.pdf | $0.00 | Terry Benton | (336) 984-8989 | 2961 Old Hiway 60 Ronda, North Carolina 28670 Map It | 2961 Old Hiway 60 Ronda, North Carolina 28670 Map It | The following materials are required to complete your application:
| BRNB42200A94A58_0013341.pdf | |||||||||||||||||||||||||||||||||||||||||||||||
| 2024-85540832 | LINDA JOBE | Email hidden; Javascript is required. | 4416 OLD JULIAN RD JULIAN, North Carolina 27283 Map It | 4416 OLD JULIAN RD JULIAN, North Carolina 27283 Map It | Euliss Propane | (336) 622-3055 | Email hidden; Javascript is required. | 5 | Payment Sent | 09/30/2024 | 09/02/2024 | Replacement or New Appliance | 1 | Replacement Installation | Rinnai | RXP-160IP REU-nbp2530FF.US | SF.BA-094852 | 09/30/2024 | Jobe-Rinnai-Invoice.pdf | $0.00 | LINDA JOBE | (336) 685-0861 | Email hidden; Javascript is required. | 4416 OLD JULIAN RD JULIAN, North Carolina 27283 Map It | 4416 OLD JULIAN RD JULIAN, North Carolina 27283 Map It | The following materials are required to complete your application:
| Jobe-Rinnai-Invoice1.pdf | |||||||||||||||||||||||||||||||||||||||||||||
| 2024-16096364 | Ashley Atkins | 7317 Denlee Rd Apex, North Carolina 27539 Map It | 7317 Denlee Rd Apex, North Carolina 27539 Map It | L.G. Jordan Oil Co., Inc. | (919) 362-8388 | Email hidden; Javascript is required. | 2 | Payment Sent | 10/03/2024 | 10/02/2024 | New Construction | 2 | Rinnai | RE1801 | 5fua083332 | 10/02/2024 | new-construction2.pdf | GE | P25930 | 52384456p | 10/02/2024 | new-construction3.pdf | $0.00 | Ashley Atkins | (919) 235-8792 | 7317 Denlee Rd Apex, North Carolina 27539 Map It | 7317 Denlee Rd Apex, North Carolina 27539 Map It | The following materials are required to complete your application:
| Atkinsbuild | |||||||||||||||||||||||||||||||||||||||||||
| 2024-20497194 | JON SPIVEY | Email hidden; Javascript is required. | 3236 JACKSON KING RD WILLOW SPRING, North Carolina 27526 Map It | 3236 JACKSON KING RD WILLOW SPRING, North Carolina 27526 Map It | K.B. Johnson Oil & Gas Co. | (919) 552-8474 | Email hidden; Javascript is required. | 5 | Payment Sent | 10/03/2024 | 09/10/2024 | Replacement or New Appliance | 1 | Replacement Installation | RHEEM | RCFZ6024STANMC | W262317360 | 09/10/2024 |  | $0.00 | JON SPIVEY | (919) 539-3380 | Email hidden; Javascript is required. | 3236 JACKSON KING RD WILLOW SPRING, North Carolina 27526 Map It | 3236 JACKSON KING RD WILLOW SPRING, North Carolina 27526 Map It | The following materials are required to complete your application:
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| 2024-13180445 | JOSH FOSTER | Email hidden; Javascript is required. | 4108 SANCROFT DR. APEX, North Carolina 27539 Map It | 4108 SANCROFT DR. APEX, North Carolina 27539 Map It | K.B. Johnson Oil & Gas Co. | (919) 552-8474 | Email hidden; Javascript is required. | 4 | Payment Sent | 10/04/2024 | 10/04/2024 | Replacement or New Appliance | 1 | Replacement Installation | RINNAI | RU199e | RH.BA-099859 | 10/04/2024 | $0.00 | JOSH FOSTER | (919) 906-1862 | Email hidden; Javascript is required. | 4108 SANCROFT DR. APEX, North Carolina 27539 Map It | 4108 SANCROFT DR. APEX, North Carolina 27539 Map It | The following materials are required to complete your application:
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| 2024-54068383 | CATHY BOWEN | 144 CHURCH ST WILLARD, North Carolina 28478 Map It | 144 CHURCH ST WILLARD, North Carolina 28478 Map It | BROOKS HEATING AND COOLING, INC | (910) 284-2222 | Email hidden; Javascript is required. | 6 | Payment Sent | 10/02/2024 | 09/27/2024 | Replacement or New Appliance | 1 | Replacement Installation | TRANE | 4YCC4036E1090A | 24178336FA | 09/27/2024 | cbowentrane.pdf | $0.00 | CATHY BOWEN | (910) 289-7582 | 144 CHURCH ST WILLARD, North Carolina 28478 Map It | 144 CHURCH ST WILLARD, North Carolina 28478 Map It | The following materials are required to complete your application:
| cbowen.pdf | |||||||||||||||||||||||||||||||||||||||||||||||
| 2024-24285050 | JIM MOSER | 1394 BRIM'S GROVE ROAD PINNACLE, North Carolina 27043 Map It | 1394 BRIM'S GROVE ROAD PINNACLE, North Carolina 27043 Map It | G&B Energy | (336) 368-3678 | Email hidden; Javascript is required. | 4 | Payment Sent | 10/04/2024 | 10/04/2024 | Replacement or New Appliance | 1 | Replacement Installation | RINNAI | RE180iP | RJ.UA-12363 | 10/04/2024 | JIM-MOSER.pdf | $0.00 | JIM MOSER | (336) 351-5159 | 1394 BRIM'S GROVE ROAD PINNACLE, North Carolina 27043 Map It | 1394 BRIM'S GROVE ROAD PINNACLE, North Carolina 27043 Map It | The following materials are required to complete your application:
| JIM-MOSER1.pdf | |||||||||||||||||||||||||||||||||||||||||||||||
| 2024-19949046 | Danny Cartner | Email hidden; Javascript is required. | 211 Grady Lane MOCKSVILLE, North Carolina 27028 Map It | 211 Grady Lane MOCKSVILLE, North Carolina 27028 Map It | G&B Energy | (336) 998-9748 | Email hidden; Javascript is required. | 7 | Payment Sent | 10/01/2024 | 10/01/2024 | Replacement or New Appliance | 1 | Replacement Installation | NPE | 180A@ | 2077x239239188 | 10/01/2024 | cartner.pdf | $0.00 | Danny Cartner | (336) 409-3883 | Email hidden; Javascript is required. | 211 Grady Lane MOCKSVILLE, North Carolina 27028 Map It | 211 Grady Lane MOCKSVILLE, North Carolina 27028 Map It | The following materials are required to complete your application:
| cartner1.pdf | |||||||||||||||||||||||||||||||||||||||||||||
| 2024-32464627 | WILLIAM GRIMME | Email hidden; Javascript is required. | 718 TYLERSTONE DR FUQUAY-VARINA, North Carolina 27526 Map It | 718 TYLERSTONE DR FUQUAY-VARINA, North Carolina 27526 Map It | K.B. Johnson Oil & Gas Co. | (919) 552-8474 | Email hidden; Javascript is required. | 27 | Payment Sent | 09/12/2024 | 09/12/2024 | New Construction | 2 | LENNOX | CK40HT-36B-01 | 1524G41652 | 09/12/2024 | RINNAI | RE199i | SD.UH-047552 | 09/12/2024 | $0.00 | WILLIAM GRIMME | (919) 422-3809 | Email hidden; Javascript is required. | 718 TYLERSTONE DR FUQUAY-VARINA, North Carolina 27526 Map It | 718 TYLERSTONE DR FUQUAY-VARINA, North Carolina 27526 Map It | The following materials are required to complete your application:
| TRIPLE A HOMES | |||||||||||||||||||||||||||||||||||||||||||
| Invoice # | Recipient Name | Customer / Recipient Email | Mailing Address | Installation Address | Company Name | Company Phone | Company Email | Application Age | Rebate Status | Rebate Expiration | Safety Inspection Date | Purchase/Invoice Date | Type of Installation | Were you affected by hurricane Helene? | What county do you live in? | How many rebates would you like to claim? | Installation Type | Rebate #1 | Appliance Type | Appliance Type | Brand | Model # | Serial Number | Installation Date | Upload Receipt | Upload Receipt | Rebate #2 | Appliance Type | Appliance Type | Brand | Model # | Serial Number | Installation Date | Upload Receipt | Upload Receipt | Rebate #3 | Appliance Type | Appliance Type | Brand | Model # | Serial Number | Installation Date | Upload Receipt | Upload Receipt | Rebate #4 | Appliance Type | Appliance Type | Model # | Brand | Serial Number | Installation Date | Upload Receipt | Upload Receipt | Rebate #5 | Appliance Type | Appliance Type | Model # | Brand | Serial Number | Installation Date | Upload Receipt | Upload Receipt | Total | Customer / Recipient Name | Customer / Recipient Phone Number | Customer / Recipient Email | Customer / Recipient Address | Customer / Recipient Installation Address | Required Materials | Upload Proof of Purchase: | Name of Builder/Contractor | Upload Spec Sheet for Manufactured Home |
