NEW CUSTOMER APPLICATION

CUSTOMER CREDIT APPLICATION
NEW CUSTOMER:
NAME
PHYSICAL ADDRESS
MAILING ADDRESS if different from above
IN CITY LIMITS? (Landrum, Campobello, or Spartanburg ONLY)

YESNO
EMAIL
example@example.com
PHONE/CELL Primary
PHONE/CELL Secondary
RECEIVE TEXT MESSAGES PERTAINING TO DELIVERIES & SERVICES?

YesNO
I UNDERSTAND THAT BY CHECKING YES TO RECEIVE RECURRING AUTOMATED TEXT MESSAGES FROM PRINCE GAS CO THAT IT IS NOT A CONDITION OF PURCHASE. MESSAGE FREQUENCY VARIES. MESSAGE & DATA RATES MAY APPLY.
PREVIOUS PROPANE SUPPLIER
PROPANE APPLIANCES USED:

GAS PACK/FURNACE WALL HEATERTANKLESS H20 HEATERTANK H2O HEATERLOGSWALL HEATERDRYERCOOKKSTOVE/RANGEGENERATORGRILLOther
IS THIS A VACATION PROPERTY?

YESNO
IS THIS A RENTAL PROPERTY?

YESNO
NAME OF RENTER
RENTER'S PHONE NUMBER
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.CALL-IN STATUS: THE CUSTOMER IS RESPONSIBLE FOR CALLING OUR OFFICE WHEN A DELIVERY IS NEEDED. CALL BEFORE THE TANK GAUGE READS 20%. AT THAT TIME YOU WILL BE PLACED ON A DELIVERY LIST AND WE WILL TRY TO GET TO YOU AS SOON AS POSSIBLE. KEEP IN MIND IT COULD BE A FEW DAYS BEFORE DELIVERY IS MADE.
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.
BUDGET: CUSTOMERS THAT ARE ON A FIXED INCOME. PRINCE GAS CO. IS RESPONSIBLE FOR SETTING THE MONTHLY BUDGET PAYMENT EACH MONTH.

AUTOMATIC PAYMENT: THIS IS FOR ANY CUSTOMER THAT WANTS THERE BANK CARD PUT ON FILE WTH US (SECURITY SAFE PORTAL) TO MAKE ANY PAYMENT ON THEIR ACCOUNT. OUR SYSTEM WILL AUTOMATICALLY CHARGE YOUR CARD WHEN YOU OWE ON YOUR ACCOUNT
TRENCHING AGREEMENT:IF PRINCE GAS CO. DIGS ANY TRENCH FOR THE GAS LINE TO PROVIDE PROPANE TO THE NEW OR EXISTING TANK, PRINCE GAS CO. IS NOT RESPONSIBLE FOR THE SETTLING OF DIRT IN THE TRENCH, OR ANY OTHER DAMAGES ASSOCIATED WITH THE DIGGING OF THE TRENCH.BEFORE PRINCE GAS CO. DOES ANY DIGGING OF ANY KIND, IT IS THE HOMEOWNERS RESPONSIBILITY TO CONTACT 811 TO GET ALL UTILITY LINES MARKED.CREDIT TERMS:I WISH TO OPEN A CHARGE ACCOUNT WITH PRINCE GAS CO. I UNDERSTAND THAT THE TERMS ARE 'NET' THIRTY DAYS FROM DATE OF PURCHASE. I FURTHER UNDERSTAND THAT A FINANCE CHARGE OF 1.5% PER MONTH WILL BE ADDED TO ALL ACCOUNTS PAST DUE. I ALSO AGREE THAT ANY FEES INCURRED IN COLLECTING MY ACCOUNT MAY BE ADDED TO THE BALANCE DUE.
SIGNATURE

Clear
DATE

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

CUSTOMER CREDIT APPLICATION

NEW CUSTOMER: