Credit Application

Name*

First Last

Spouse's Name*

First Last

Email*

Home Phone*

Work Phone

Cell Phone

Cell Phone (Spouse)

Address*

Street Address Address Line 2 City State ZIP Code

Use Delivery Address as Billing Address

Billing Address

Street Address Address Line 2 City State ZIP Code

How long have you been at the current address?*

Do you rent or own this property?*

If renting, who would be responsible for service billing?*

Landlord's Name

First Last

Landlord's Address

Street Address Address Line 2 City State ZIP Code

Landlord's Phone

Former Residence

Former Fuel Supplier

Are you currently employed?*

Occupation

Place of Employment

How long?

Place of Employment (Spouse)

How long? (Spouse)

Fuel Type*

Is fuel used to supply hot water?

Fuel Pipe Location (if you were looking at the front of the house)

Tank Size (gallons)

Delivery Instructions (house color/style)

How did you hear about us?

Consent

I understand and agree that by signing my name below Sherman Oil will use the information above to determine my eligibility to open a credit account.

Digital Signature*

Date*

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