ESTABLISHED 1961
MY ACCOUNT LOGIN
|
PAY ONLINE
301-725-5550
|
301-776-7550
301-725-5550
|
301-776-7550
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Residential Application
This application is subject to credit check.
Your Information
*
Name:
Mr.
Ms.
Mrs.
Formerly:
Account #:
Social Security #:
Driver's License #:
Spouse Name:
Mr.
Ms.
Mrs.
Spouse
Social Security #:
Spouse
Driver's License #:
Billing Address:
AL
AK
AR
AZ
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CO
CT
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DE
FL
GA
HI
IA
ID
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MA
MD
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NY
NV
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OK
OR
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SC
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VT
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Delivery Address:
AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Phone:
Work:
Other:
*
Email Address:
Employment Information
Employer:
Address:
AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Phone:
Supervisor:
How Long Employed:
Type of Work:
Spouse Employer:
Address:
AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Phone:
Supervisor:
How Long Employed:
Type of Work:
Name Of Nearest Relative:
Address:
AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Phone:
Housing
Own
Rent
Landlord:
Landlord's Address:
AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Landlord's Phone:
*
Landlord's Email:
Delivery
Fuel Oil Delivery
Kerosene Delivery
Delivery Type
Automatic Delivery
Will Call Delivery
Account Type
30 Day Account
Budget Account
C.O.D. Account
Do You Use Fuel Oil To Heat Water For Domestic Use?
Yes
No
Gallons
All budget accounts MUST apply by September 1st and include gallons used per year.
All deliveries will be C.O.D. until credit application is approved. Payment is due upon receipt of invoice. Invoices not paid within 30 days are subject to 1.5% per month late fee until the account is paid in full. If the account is referred to a collection agency or an attorney for collection, I/we shall be responsible for the attorney's fees, collection agency fees plus any costs associated with collection.
Please check the checkbox to verify:
Become a Customer
Commericial Application
Residential Application