The undersigned (“Customer”) states that all of the foregoing information is true and correct and requests that Western States Oil extend credit, and/or continue previously extended credit, to Customer, in material reliance upon such information. The undersigned provides authorization to release any information necessary toward the processing of an account application with Western States Oil. This information will be kept strictly confidential. The undersigned has read and agrees to the Terms and Conditions (and Additional Cardlock Terms and Conditions if applicable) attached to this agreement and agrees that all of these Terms and Conditions are binding on the Customers. Facsimile and scanned signatures shall have the same force and effect as an original signature.