Credit Application

Interested in becoming a new Peterson Oil Customer? Just fill out the form below, and a Peterson Oil representative will contact you as soon as possible.

Applicant Name:	SS Number: (Optional)
Phone: () -	E-mail:
Delivery Address:            Street:
City:         State:         Zip:
Check if Address is The Same For Billing
Billing Address:               Street:
City:         State:         Zip:
Delivery Remarks:
Special Instructions:
Can Driver park in the driveway if fill pipe is less than 125 from the street? Yes No
How did you hear about us?
Fill Location: (Click approx. location eg. BL = back left) BL BC BR LR RR LC RC LF RF FL FC FR
Complete If Your Are a Tenant
Landlord's Name:	Phone:
Does Landlord have an account? Yes No
Account No.:
Landlord's Address:           Street:
City:         State:         Zip:
Are you responsible for Service? Yes No
Phone:
Delivery Information
Tank Size:	No. of Occupants:
Current Volume in Tank:	Home Square Footage:
Would you like automatic delivery? Yes No
Heating System Information
Type of Heating System (click one): Steam Warm Air  Forced Hot Water
No. of Zones:               Is water heated by oil? Yes No
Hot water heater make:
Do you have a free-standing Unit? Yes No
Do you have a tankless unit? Yes No
Is your hot water storage tank connected to your boiler? Yes No
Furnace/Boiler make: Is your house air-conditioned? Yes No
Date of last maintenace:
Schedule cleaning or ultimate inspection? Yes No      When?
Credit Information
Please read the terms and conditions:
Applicant 1:
Employer:	No. of Years:
Phone:                    Previous address (if < 2 years):
Applicant 2 (if applying jointly):
Employer:	No. of Years:
Phone:                    Previous address (if < 2 years):
Applicant #1 Signature:	Date:
Applicant #2 Signature:	Date:
I've read and understand the terms and conditions (linked to above), and the Peterson Customer Information Handbook. Please correctly type in the following phrase to verify: Please type p.e.t.e.r.s.o.n. without the periods in the box to the right.