Commercial Credit Application - Sourdough Fuel Co.-Sourdough Fuel

Commercial Credit Application - Sourdough Fuel Co.

Sourdough Fuel is a subsidiary of Petro Star Inc. (Please type a response to all questions)

This is a request for (check all that apply)

Heating Oil Delivery (complete tank information below)

Bulk Plant pick up

Fuel cards

Business Name

Phone Number

Fax

Mailing Address

Physical Address

Federal Tax I.D. Number

Are PO's required?

AP Contact

How many years doing business under present name?

Amount of Monthly Desired Credit

Tax Exempt Status

Invoices and Statements will be emailed.

Email address to send invoices/statements

If Sole Proprietor or Partnership:

Name #1

Address #1

Phone Number #1

Name #2

Address #2

Phone Number #2

Name #3

Address #3

Phone Number #3

If Corporation:

State of Incorporation

Date of Incorporation

Date Registered in Alaska (if out of state)

Alaska Agent

Address

Phone Number

President

Address

Phone Number

Other Persons Authorized to Purchase on Account:

Account Agreement

I promise that everything stated in this application is correct to the best of my knowledge. I agree to furnish accurate financial statements upon request. And, I authorize you to obtain credit reports in connection with this application. I also promise to pay for all charges billed for goods and services per invoice terms. Late payments will be accessed a finance charge. If this account becomes delinquent and is assigned to a collection agency, a collection fee will be added to the balance of the account and charged to me.

Title:

Date:

Your Signature

By:

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 fuel 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.

The following fields are instructions for our Dispatch and Drivers

Please be as accurate as possible to avoid misdeliveries.

Physical Address:

Directions to Home or Building:

500

House or Building 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 location

Tank size (We do not deliver to barrels.)

Is the tank Above Ground or Below Ground? (We do not deliver to barrels.)

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

Automatic delivery?

Yes

Tank Size (We do not deliver to barrels)

Is the Tank Above ground or Below ground? (We do not deliver to barrels)

Above

Below

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

Yes

If yes, please provide information: