Residential Credit Application - Sourdough Fuel Co.-Sourdough Fuel

Residential Credit Application - Sourdough Fuel Co.

Sourdough Fuel is a subsidiary of Petro Star Inc. (Please fill out all applicable fields before submission)

First Name

Last Name

Birthdate

Cell Phone Number

Social Security #

Employer

Phone Number

Length of Employment

Position

Monthly Income

Co-Applicant

Birthdate

Cell Phone Number

Social Security #

Employer

Phone Number

Length of Employment

Position

Monthly Income

Mailing Address

Physical Address

Invoices and Statements will be emailed

Email:

Length at Current Address

Amount of Mortgage or Rent Payment

Choose

Own

Rent

If Renting, Name of Landlord

Name of Personal Reference

Phone Number

PROMISE TO PAY

I promise that everything stated in this application is correct to the best of my knowledge. I also promise to pay Sourdough Fuel for all charges billed for goods and services within 30 days of invoice/billing. Should I default, I understand that automatic deliveries will be suspended if satisfactory arrangements have not been made. Default is failure to pay the full amount of all charges within 30 days after billing, or for Budget Plan customers, when the required monthly payments are not paid as agreed. Late payments will be assessed a finance charge of .875% per month. I hereby authorize Sourdough Fuel to obtain credit reports in connection with this application. If this account becomes delinquent and is assigned to a collection agency, a collection fee will be added to the delinquent balance and charged to me.

Applicant's Signature

Date

Co-Applicant's Signature

Date

Are you interested in Automatic Delivery or Will Call service?

Automatic Delivery (please fill out request)

Will Call

REQUEST FOR AUTOMATIC DELIVERY OF HEATING OIL

I authorize Sourdough Fuel to deliver heating fuels and to keep an adequate supply in my storage tank at all times without further notice and to thereby provide Automatic Delivery Service to:

Delivery Address: (For additional deliveries, please contact us after approval.)

In addition to authorizing Sourdough Fuel to run credit checks as needed, I further agree that any and all purchases and deliveries from Sourdough Fuel will be governed by the Sourdough Fuel Terms and Conditions attached hereto and incorporated fully herein.

Applicant's Signature

Date

Co-Applicant's Signature

Date

BUDGET PAYMENT PLAN

Avoid high winter fuel bills by prorating your annual use over a predetermined number of months. We recommend beginning in August and ending in June. Notification of our payment plan will be sent in July.

Are you interested in our Budget plan?

Yes

The following fields are instructions for our Dispatch and Drivers

Please be as accurate as possible to avoid misdeliveries

Physical Address:

Directions to Home:

500

House Description

500

Do you need to be called before delivery? (Unnecessary calls may delay your delivery)

Yes

If so why?

May we text you a message and make delivery?

Yes

Dogs:

Yes

How many?

Are they kept:

Inside

Outside

When was the last delivery?

Was the tank filled?

Yes

Who was the last fuel supplier?

When do you want the first delivery?

Primary Heating Oil Tank Locations:

Tank Size (We do not deliver to barrels):

Tank Above Ground or Below Ground?

Above

Below

(If you have another tank at this physical address, please provide the following information for the additional tank.)

Secondary Heating Oil Tank Location:

Autofill:

Yes

Tank Size (We do not deliver to barrels):

Tank Above ground or Below ground?

Above

Below

Are there tanks on the property other than a heating oil tank? (Water, propane)

Yes

If yes, please provide information: