Price Protection Contract

PRICE PROTECTION PROGRAM
*ARE YOU INTERESTED IN A 2025/2026 PRICING PLAN?
ACCOUNT NUMBER (EXISTING CUSTOMERS)
APPLICANT CONTACT INFORMATION*

First NameMiddle NameLast NameSuffix
COAPPLICANT CONTACT INFORMATION

First NameMiddle NameLast NameSuffix
BILLING ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is your Delivery Address the same as your Billing Address?

YesNo (please add below)
DELIVERY ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
BEST PHONE NUMBER*

Area CodePhone Number
EMAIL*
example@example.com
PREFERRED CONTACT METHOD*

EMAILCELL PHONEHOME PHONEWORK PHONE
DESIRED PROGRAM (MUST SELECT ONE)*

OIL PREPAY PLAN -- PLEASE CALL THE OFFICEOIL BUDGET PLAN -- PLEASE CALL THE OFFICEOIL 10-DAY PLAN** -- PLEASE CALL THE OFFICEMARKET PRICE PLAN - FLUCTUATES
ARE YOU A SENIOR CITIZEN? (65+ - $0.02 PER GALLON DISCOUNT)

YESNO
**COMPLETED & APPROVED CREDIT APPLICATION MUST BE ON FILE.
ADDITIONAL CUSTOMER INFORMATION
TOTAL GALLONS USED IN PREVIOUS SEASON?
IMPORTANT: Please provide the TOTAL amount used last season.
NUMBER OF GALLONS TO RESERVE FOR THIS SEASON?*
IMPORTANT: Please do not underestimate as any gallons used over reserved amount will be billed at market rate. If unsure, please contact our office for assistance.
DELIVERY METHOD PREFERENCE

AUTOMATICWILL CALL
--IMPORTANT: Choose "A" or "B" below BUT NOT BOTH--
A. AUTOMATICALLY CHARGE MY CREDIT CARD FOR OIL/BUDGET PAYMENTS. ($0.05 per gallon credit card convenience fee will be added)

YESNO
B. FOR MONTHLY BUDGET CUSTOMERS ONLY - AUTOMATICALLY DRAFT MY MONTHLY BUDGET PAYMENT FROM MY CHECKING OR SAVINGS ACCOUNT. (Please contact the office for the E-Check or ACH form. A completed & approved form must be on file)

YESNO
I AM INTERESTED IN CAP PRICING (Allows price to decrease if the Market Rate dips below the contracted price. Non-refundable Cap fee of $0.25/gallon paid up front.)*

YESNO
PLEASE ADD THE COST OF ALL SERVICE CONTRACTS TO MONTHLY BUDGET PLAN.

YESNO
IF I AM THE LANDLORD, THE TENANT HAS MY PERMISSION TO CALL CHESTER COUNTY FUEL OIL FOR SERVICE AS NEEDED.

YESNO
I CURRENTLY HAVE

FURNACEBOILEROIL H/W HEATER
TANK SIZE

275 (STANDARD)NOT SUREOTHER SIZE
RESIDENCE INFORMATION

I OWN & RESIDE IN THE HOMEI RENT THE HOME FROM SOMEONE ELSEI'M THE LANDLORD AND RENT OUT THE PROPERTY TO TENANT
LOCATION OF FILL SPOUT?
TANK LOCATION?
ANY ADDITIONAL DETAILS?
*Price protection plans are subject to availability and pricing is subject to change without notice. The elected Price Protection Plan will automatically renew each year, unless otherwise stipulated in writing prior to the contract renewal date.
Applicant's Electronic Signature (Type Name)*
Co-Applicant's Electronic Signature (Type Name)
Should be Empty:

PRICE PROTECTION PROGRAM

*ARE YOU INTERESTED IN A 2025/2026 PRICING PLAN?

ADDITIONAL CUSTOMER INFORMATION