W.O. STINSON & SON APPLICATION FOR PROPANE HEATING

APPLICANT

Name*
Billing Address*
City*
Province*
Postal Code*
Date of Birth (yyyy/mm/dd)*
Employer*
SIN*
Previous Address (if less than one year at current)
Address (if different)
Delivery Instructions
Telephone (with area code)*
(Home)
(Office)
(Cell)
(Email)

CO-APPLICANT

Name
Billing Address
City
Province
Postal Code
Date of Birth (yyyy/mm/dd)
Employer
SIN
Previous Address (if less than one year at current)
Telephone (with area code)
(Home)
(Office)
(Cell)
(Email)

PROPANE INFORMATION

Propane Delivery
Propane tank size
Amount in tanks
Propane For
Water Heater
For more information on Furnace Protection Plan, click here

*   Please check this box to indicate that you have read and agree to the terms below.
I have read and accept your offer to supply my entire requirements of Heating Oil at the delivery address shown above and as such I personally guarantee to pay all balances due to W.O. Stinson & Son Limited regardless of legal identity of business and agree to the Terms of Credit. Terms: Net 30 days. 2% per month (26.82% per annum) on overdue accounts. A collection fee of 25% of the unpaid balance will be charged if in the opinion of W.O. Stinson & Son Limited, a collection agency or lawyer would be requested to obtain payment for any outstanding amounts.

NOTES:
 
Our Privacy Policy

 

Net 30 days, 2% per month (26.82% per annum) on overdue amount.

We certify that the above information is true and accurate and we authorize you to verify our credit worthiness in any reasonable manner you deem appropriate.