Account Application Contact Information Email Statements:YesNo How did you hear about us? Select one:Word of MouthFacebookYellow PagesInternet SearchOther Personal Information Birth Date: Month (01) January(02) February(03) March(04) April(05) May(06) June(07) July(08) August(09) September(10) October(11) November(12) December Day 12345678910111213141516171819202122232425262728293031 Year 20052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947 Own or Rent:OwnRent Ordering Information Fuel Tank Location: Would You Prefer Automatic Delivery? YesNo Products Required: Furnace OilPropaneOther Employment Information CUSTOMER agrees to purchase from MacGillivray Fuels and MacGillivray Fuels agrees to sell to the CUSTOMER his entire fuel requirements at the specified address subject to credit approval commencing on the date indicated below. CUSTOMER shall give written notice to MacGillivray Fuels of CUSTOMER's intent to vacate the premises. Purchases are due and payable on receipt of the invoice, without credit cost. However, a credit cost of 2% per month (26.82% per annum) shall apply to any past due balance. Such credit cost may be modified from time to time by MacGillivray Fuels upon notice. If on automatic delivery, MacGillivray Fuels shall endeavor to maintain at all times a sufficient fuel supply in the CUSTOMER'S tank(s). However, CUSTOMER shall forthwith advise MacGillivray Fuels should fuel level in tank(s) drop below normal, and shall inform MacGillivray Fuels in writing of any modification affecting the storage capacity of the tank(s) or CUSTOMER'S needs, so that deliveries can be planned accordingly. If account should become past due automatic delivery could be interrupted without notice to the customer. MacGillivray Fuels shall not be responsible for any damage resulting from any inadequate reserve level of fuel, if delivery address remains unoccupied by an individual, or if, for any reason whatsoever, fuel consumption is unusually high or if, for any reason beyond MacGillivray Fuels control, MacGillivray Fuels is prevented or delayed in making its fuel deliveries. The CUSTOMER HEREBY REQUESTS CREDIT FROM MACGILLIVRAY FUELS FOR THE PURCHASE OF FUEL. The customer is notified that a report as to credit and other information is to be obtained for credit now applied for and any transaction from time to time related thereto. The customer acknowledges and consents to the disclosure of any credit or personal information in the possession of MACGILLIVRAY FUELS to any credit grantor or consumer reporting agency with whom MACGILLIVRAY FUELS may transact. Printing your name here constitutes a signature for the purposes of this application Today's Date: Month (01) January(02) February(03) March(04) April(05) May(06) June(07) July(08) August(09) September(10) October(11) November(12) December Day 12345678910111213141516171819202122232425262728293031 Year 2024202520262027202820292030 Δ