Allstar Fuel. Fred Garrison Oil Company Credit Application Check List. (Attach Photocopy of Permit) (Attach Photocopy of Permit)

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1 Fred Garrison Oil Company Credit Application Check List Date Approved: Approved by: Customer Acct No: Check Required Forms 1 X CREDIT APPLICATION (Page 1 & 2) Office Use 2 PERMIT TYPES (TO EXPEDITE APPROVAL PLEASE INCLUDE COPY OF ALL PERMITS) DISTRIBUTOR # GASOLINE JOBBER # DIESEL AVIATION FUEL DEALER # GASOLINE DYED DIESEL FUEL BONDED USER # AGRICUTURAL BONDED USER # JET DD- END USER SIGNED STATEMENT (Complete form and Sign) AG - AGRICULTURAL EXEMPTION (Complete form and Sign) DD (Blank Form Attached) AG (Blank Form Attached) 3 X ELECTRONIC FUNDS TRANSFER AUTHORIZTION AGREEMENT X Photo copy of check with routing and account number 4 X TNRCC - Petroleum Storage Tank Delivery Certificate (PST05) 5 X Sales & Use Tax Permit (Form ) # 6 Authorization to check credit on customer letterhead 7 6/14/2013/4:55 PM CREDIT APPLICATION Check List.xls/Standard Customer

2 CREDIT APPLICATION & AGREEMENT 1 Location Information Account Name Location Street Address Business Billing Address Location Phone # Fax # Phone & Cell # Fax # Fuel Permit # Permit Type State 2 Corporate Information Legal / Corporate / Business Name ENTITY TYPE: (Check one) Corporation Partnership LLC FEIN List Owners Officers or Partners Names Title Address 3 Bank Information Bank Name City / Branch Account # Officer Phone#/FAX# Checking 4 Credit References Name Phone # Account # Amount Owed Estimated Credit Needed Approved By Date For Office Use Only Credit Limit Page 1 of 4

3 5 Contractual Agreements 1. Do you have an existing contract, whether written or verbal, to purchase fuel from any fuel supplier other than Allstar Fuel at this time? 2. Does any third party fuel supplier or entity of any kind own any of the pumps, tanks, line, product dispensers, equipment or facilities used in conjunction with the fuel dispensing system in operation at your business premises? Questions must be answered prior to submitting application for credit approval. 6 Credit Agreement & Authorization I hereby make application to Fred Garrison Oil Company, PO Box 100, Plainview, Texas , and authorize them to obtain credit reports and information about the applicant, and conduct an inquiry with regard to credit information about the accounts of the applicant, and specifically authorize the persons or companies listed on this application to provide information to Fred Garrison Oil Company or its assignees with respect to the accounts of the applicant. If credit is extended to me, I agree to pay my account in full not later than the 8 th day following the delivery. I further agree to pay a $30 late fee if payment is not made by the due date, plus a finance charge of 1 ½% per month, or 18% annual percentage rate on any past due balance. If my account becomes delinquent and is referred to an outside attorney or collection agent, I agree to pay all fees and court costs permitted by law. I certify that the information on this form is true and correct, and hereby authorize Fred Garrison Oil Company to use the above information in conjunction with an evaluation of credit. Signature Date Executed Page 2 of 4

4 7 Electronic Funds Transfer Authorization Agreement The customer identified on this application ( Customer ) hereby authorizes Fred Garrison Oil Company for its own account and for the account of its divisions, subsidiaries, and affiliates to initiate electronic funds transfer debit and credit entries to Customer s deposit account indicated below, and does further authorize the financial institution named below to debit or credit such entries to the Customer s account. Attach copy of voided check. Account Name Bank Name Bank Address Branch Bank Contact Phone # Bank Transit & Routing (ABA) # Bank Account # Account Type: Checking Savings This authority shall remain in effect until terminated at the sole discretion of Fred Garrison Oil Company or upon thirty (30) days written notice by the Customer received at our office at 1107 Walter Griffin Street, Plainview, Texas Notice of termination shall in no way affect debit or credit transactions initiated prior to actual receipt of notice. I certify that the information on this form is true and correct, and hereby authorize Fred Garrison Oil Company to use the above information in conjunction the EFT program. Print Name of Authorized Signer Title of Authorized Signer Signature Date Executed Page 3 of 4

5 8 Personal Guaranty: Business and Corporation only Unconditional Guaranty To: Fred Garrison Oil Company 1107 Walter Griffin St. Plainview, Hale County, Texas For value received, the undersigned (Guarantors) jointly, severally and unconditionally guarantee and promise to pay to Fred Garrison Oil Company (Seller) or its assigns at the above address, all indebtedness by (buyer, entity name), of City County State, by reason of the purchase from Seller of petroleum products including without limitation gasoline, diesel and lubricants. 2. Guarantors understand and agree that this is a continuing guaranty, and until revoked as hereinafter provided, shall cover all existing and future indebtedness of Buyer as contemplated under this agreement, including indebtedness arising under successive transactions and accounts. 3. This guaranty shall terminate on delivery to Seller, at the address set forth above, of notice of termination effective as to any and all indebtedness incurred or created by Buyer from and after such delivery of notice of termination. Dated You may fax your completed Credit Application & Agreement to (806) or mail to Fred Garrison Oil Company, PO Box 100, Plainview, TX For additional information call (806) Page 4 of 4