PROPANE TANK OWNERSHIP AFFIDAVIT

SWAN FUEL SERVICE, INC
PROPANE TANK OWNERSHIP AFFIDAVIT
I(Customer Name)* , residing at (Property Address/Location of Propane Tank)* . verify I wholly own the(Tank Size)* gallon capacity propane tank with the serial number of (Tank Serial Number)* located at/on the property identified above. I further verify, I do not have any contractual obligations, service or supply contracts, with any propane company relating to the above propane tank(s).
By signing below I, ("Customer") certify that I am the owner of the above-referenced tank(s) and hereby grant permission to Swan Fuel to fill tank(s) per customer agreement with Company. If it is discovered at a later date that any tank(s) are not my property, I agree to hold Company harmless for any costs or penalties that may arise from this discovery. It is also understood that until tank ownership status can be clarified, Company shall cease filling tank(s
Customer Name Printed
Customer Signature

Clear
Date

MonthDayYear
Date
Swan Fuel reserves the right to contact other area propane companies to resolve any discrepancies regarding any propane tank ownership.
Should be Empty:

SWAN FUEL SERVICE, INC