ENERGY STAR® with NEEM+ Sales challenge

Sales Notification Form

Retailer Company

Salesperson Name

First Name

Last Name

Phone

(###)

###

####

Email

Order Information

Date Order Placed with the Factory

MM

DD

YYYY

Factory's Estimated Date of Completion (if known)

MM

DD

YYYY

Manufacturer

Home Model Number

Customer Information

Customer Name

Siting Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country