APPLICANT INFORMATION:





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CO-APPLICANT INFORMATION:





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DELIVERY ADDRESS:








BILLING ADDRESS:








OTHER REQUIRED INFORMATION:

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CREDIT TERMS AND CONDITIONS


Customer agrees to pay all fees, rates and charges within 15 days of the invoice date to H.A. George and Sons Fuel Corp. If customer fails to pay any fees, rates and charges when due, H.A. George may add a finance charge of 1.5% per month (18% annually) to all 30 day past due balances. H.A. George reserves the right to require payment in advance. If H.A. George files suit against Customer to enforce any of the terms and conditions of this Agreement or to recover possession of any of its equipment, the Customer shall pay H.A. George reasonable cost, including attorney's fees, to the maximum extent permitted by law. Under no circumstances will a credit report be directly or indirectly accessed by, or passed on to, any other business entity or individual unrelated to H.A. George and Sons Fuel Corp. or be used for any other permissible purpose other than for evaluating the credit worthiness of new customers to extend net 30 day credit for the purchase of propane and/or heating services.

I/We fully understand your credit terms and agree to the proper payment of extended credit. I/We hereby certify that the facts set forth in the above application are true and complete to the best of my/our knowledge. You are herby authorized to make any investigations concerning my financial standing and/or credit record through any investigative or credit agencies.

If this form is not filed or returned than the account will be COD or deliveries held until information is obtained.

By checking this box you agree that you have read and understand the terms above:

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