6. Credit Agreement

Arrick’s Propane Credit Terms

To establish credit, you must completely fill out this credit agreement. Once credit is established, payment is due in ten days. A service charge of 2% per month, which is 24% per annum, will be charged on all accounts 30 days and over. All accounts over 60 days are placed on a permanent cash-only basis. No deliveries are made on accounts with an open balance. Please return this agreement as soon as possible. Deliveries will not be made until the credit agreement is processed unless paid for in advance.

PLEASE COMPLETE ALL LINES. Incomplete information may delay ability to charge.

Account Number

Name*

First NameLast Name

Street*

Apt #

City.*

State*

Zip Code*

Email Address*

example@example.com

* Once this credit application is processed, all statements will be emailed *

Please check the statement that applies to you:*

I own my own homeI am rentingI am buying on land contract

Tank will be used for"*

My own useA rental property

I would like to be contacted about the cost saving automatic delivery programs Arrick’s Propane offers

Yes

I understand and agree to the credit terms and state that the information provided is true to the best of my knowledge.

Customer Signature*

Date*

Date