Residential Credit Application

    Spouse / Co-Applicant
    Please Give Mailing Address if Different Than Above
    Current Residence How long at the present address?
    Do you own or rent?
    Is this a Mobile Home?
    Previous Address
    Previous Oil or Gas Company
    SURVEY In an effort to better serve our customers, please take a moment to fill out the information below, so that we can better predict your LP gas needs. We (I) typically use LP gas for:
    If gas pack, gas logs or free standing/water heater selected, how many units?
    Refill rate:
    Type of Oil:
    TERMS AND CONDITIONS: 1. All accounts are due and payable by the 10th of the month following delivery or purchase. There will be a 1 ½% service charge added to all past due balances. (Minimum charge $20.00) 2. No deliveries will be made to customers that have an outstanding balance. 3. If account remains unpaid after due date, we may deem the following actions necessary: A. Turn accounts over to a collection agency. B. Report delinquent account to the nationwide Credit Bureau. C. Have our corporate lawyer issue a judgment. D. Pick up any tanks supplied by us to our customers as a service. 4. Customers may also have the option of setting the account up on a Budget Plan, the Budget Plan runs from August through June of the following year. You will pay a certain amount every month beginning in August, however, all accounts MUST BE PAID IN FULL BY JULY 25TH OF EACH YEAR. 5. LP Gas customers who do not wish to set up an account, or are denied credit, are required to pay up front for the tank setting fee, parts and fittings, and the amount of gas in the tank. These fees must be paid before we set the tank. If you have moved to a residence that already has our tank then the amount of gas in the tank and the regulator reconnection fee must be paid up front. We trust that you understand the reason for our position is to serve our customers more efficiently and economically. Therefore, we must follow these guidelines. We (I), acknowledge that the LP Gas Tank is loaned from Creedmoor Fuel Service, Inc. and that Creedmoor Fuel Service, Inc. is the rightful owner of the tank. We (I) agree to notify Creedmoor Fuel Service, Inc. if there is any change of ownership of the property on which the loaned tank sits. Furthermore, we (I) grant Creedmoor Fuel Service, Inc. access to the property in order to service, repair, or remove the LP Gas tank, and hold Creedmoor Fuel Service, Inc. blameless for any damages caused to property while servicing, repairing, or removing the LP Gas tank.