NEW CUSTOMER APPLICATION

NAME

PHYSICAL ADDRESS

MAILING ADDRESS if different from above

IN CITY LIMITS? (Landrum, Campobello, or Spartanburg ONLY)

EMAIL

example@example.com

PHONE/CELL Primary

Format: (000) 000-0000.

PHONE/CELL Secondary

Format: (000) 000-0000.

RECEIVE TEXT MESSAGES PERTAINING TO DELIVERIES & SERVICES?

I UNDERSTAND THAT BY CHECKING YES TO RECEIVE RECURRING AUTOMATED TEXT MESSAGES FROM PRINCE GAS CO TO THE ABOVE LISTED NUMBER, THAT IT IS NOT A CONDITION OF PURCHASE. I UNDERSTAND THAT I WILL RECEIVE NO MORE THAN 4 MESSAGES A MONTH. MESSAGE & DATA RATES MAY APPLY. PLEASE REPLY STOP TO OPT OUT.

PREVIOUS PROPANE SUPPLIER

PROPANE APPLIANCES USED:

IS THIS A VACATION PROPERTY?

IS THIS A RENTAL PROPERTY?

NAME OF RENTER

RENTER'S PHONE NUMBER

Format: (000) 000-0000.

All RENTAL PROPERTY IS CONSIDERED COD (CASH ON DELIVERY) AT THE DELIVERY THE CUSTOMER MUST PAY AT TIME OF DELIVERY OR BEFORE DELIVERY.

PO BOX 101, 1506 E. RUTHERFORD ST. LANDRUM, SC 29356 (864)457-2490 EMAIL: PRINCEGASCOMPANY@GMAIL.COM

AUTOMATIC OR CALL- IN DELIVERY STATUS: (PLEASE CHOOSE A DELIVERY STATUS)

AUTOMATIC STATUS: (250 GALLON TANK OR LARGER) THE CUSTOMER CHOOSES TO BE ON OUR AUTOMATIC ROUTE SCHEDULE. DURING THE WINTER MONTHS WE WILL DELIVER 4-6 WEEKS. WE ALSO MAKE A LATE SUMMER DELIVERY FOR AUTOMATICS. PRINCE GAS CO., INC. IS NOT RESPONSIBLE IF THE CUSTOMER RUNS OUT OF GAS. THE CUSTOMER IS RESPONSIBLE FOR KEEPING A CHECK ON THE TANKS GAUGE INDICATING PERCENTAGE OF PROPANE IN THE TANK. IF IT IS AT 20% CALL US. TO KEEP THE AUTOMATIC DELIVERY STATUS ALL INVOICES MUST BE PAID NO LATER THAN 30 DAYS OF DATE OF INVOICE.

IF YOU CALL IN STATING THAT YOU HAVE RUN OUT OF GAS, WE MAY OR MAY NOT BE ABLE TO GET YOU THAT SAME DAY. THERE WILL BE A DELIVERY CHARGE OF $75.00. WE ARE REQUIRED BY LAW TO PERFORM A LEAK TEST ON YOUR SYSTEM AND YOU MUST BE AT HOME WHEN THE DELIVERY IS MADE.

INTERESTED IN

BUDGET: CUSTOMERS THAT ARE ON A FIXED INCOME. PRINCE GAS CO. IS RESPONSIBLE FOR SETTING THE MONTHLY BUDGET PAYMENT EACH MONTH.

SIGNATURE

DATE

Date

PO BOX 101, 1506 E. RUTHERFORD ST. LANDRUM, SC 29356 (864)457-2490 EMAIL: PRINCEGASCOMPANY@GMAIL.COM

CUSTOMER CREDIT APPLICATION

NEW CUSTOMER: