Oil Company Incorporated

Similar documents
COEN CARD APPLICATION AND ACKNOWLEDGEMENT OF TERMS

Store Phone Office Fax. Office Phone or Cell 24 Hour Emergency Phone. Address Web Site Address

THE PEOPLES BANK OF MULLENS MAKING CHANGES HAPPEN

B U SINE SS ACCOUNT CREDIT APPLICATION

LYNCH OIL COMPANY, INC. Toll Free (800) P.O. BOX Fax (407) KISSIMMEE, FLORIDA

Payrolls Unlimited, Inc.

Avella Wholesale, Inc.

FAX COVERSHEET PLEASE FIND ATTACHED: Agency Appointment Forms. VIP Roadside Assistance Forms. ACH form for sweep set up Voided Check

PAYROLL DIRECT DEPOSIT FORM

Easy Switch Kit Banking Made Simple

Section 125/FSA Set-up Form

DOCUMENT CHECKLIST FOR FUNDING

Switch Kit Checklist. Remember, East Idaho Credit Union is here to assist every step of the way. Stop by your local EICU branch today and let us help.

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

SWITCH TO FIRST CENTURY BANK. It s not as hard as you think.

Welcome To Tri-County Technical College

CREDIT APPLICATION & AGREEMENT

WAKE COUNTY, NORTH CAROLINA Information & Instructions for Vendor Enrollment Form (PLEASE READ ALL INSTRUCTIONS CAREFULLY)

GRAND RAPIDS CRANE CO LLC.

Texas Family Physicians Medical Membership Program

Engineers Flying Club Inc.

SWITCHING IS EASY. Switch Kit. A simple solution to transfer your accounts and services.

Business Deposit Account Application - Partnership

transfer automatic deposits to your new account transfer automatic withdrawals to your new account

COMMERCIAL ACCOUNT APPLICATION

COEN CARD APPLICATION AND ACKNOWLEDGEMENT OF TERMS NEW CUSTOMER

1804 NW Martin Road ~ Forest Grove, OR ~ Phone: (503) ~~ Fax: (503) or

Application for Utility Account Property Folio #

New Account SWITCH KIT (rev Dec 2014) SWITCHING MADE EASY. Welcome To Progressive Ozark!

*SLA LICENSE SERIAL #: *NY STATE TAX ID #:

NATIONAL INSURANCE UNDERWRITERS, LLC. AUTO PRODUCER S AGREEMENT

Application for Customer Status

GRAND SAVINGS BANK S SWITCH KIT

BECK EQUIPMENT, INC Preble Rd, Preble, NY Toll Free: (866) / Fax: (607)

RIVERSIDE ACADEMY TUITION & FEE SCHEDULE Tuition Rates

Name: DOB: Relationship: Name: DOB: Relationship: Name: DOB: Relationship: Name: DOB: Relationship: Name: DOB: Relationship:

THANK YOU FOR YOUR INTEREST IN BILL HICKS & CO., LTD

Complete the following steps to apply:

MERCER MARKETPLACE 365 HRA INSTRUCTIONAL GUIDE

Welcome to. Consumer Account Switch Guide

DNB First Checking Savings

Tired of Being Chained

The Peoples Bank Business Switch Kit

M O D E L R E C T I F I E R C O R P O R A T I O N 80 NEWFIELD AVENUE FAX: EDISON, NEW JERSEY USA TEL:

Hartford Funds Automatic Investment Form

Payment Processing Supporting Documentation Request

USED AUTO LOAN REQUIREMENT

QUALIFYING CRITERIA, GUIDELINES, & RENTAL APPLICATION

Overdraft and Courtesy Pay FAQ

Farm Credit Application: Part A Account #:

Switch Kit. Be sure to leave sufficient funds in your former account to cover any outstanding checks and automatic payments.

NEW ACCOUNT PACKETS INCLUDE: PLEASE RETURN ORIGINIALS TO THE CREDIT UNION

A. Current account owner(s) Complete section 2, you may need to obtain a Medallion Guarantee. B. New account owner(s) Complete sections 3 through 10.

MERCER MARKETPLACE 365 HRA INSTRUCTIONAL GUIDE

Lift Works, Inc. Credit Application

Use Fuel User COMPLIANCE GUIDE

MAK E THE SWITCH. Member FDIC

Take advantage of convenient Lake City Bank services like Internet

Funding Address: HONOR FINANCE, LLC 1214 First Ave. Suite 550 Columbus, GA F U N D I N G R E Q U I R E M E N T S

MONTEFIORE CONTRACT MANAGEMENT ORGANIZATION CMO (13174) ERA ENROLLMENT INSTRUCTIONS

APPLICATION FOR MEDICARE SUPPLEMENT INSURANCE * UNITED AMERICAN INSURANCE COMPANY A LEGAL RESERVE STOCK COMPANY

EMPLOYER GROUP ENROLLMENT APPLICATION

AGREEMENT AND FEE FORMS

PREFERRED LOAN REQUIREMENT

MERCER MARKETPLACE 365 HRA INSTRUCTIONAL GUIDE

LINN COUNTY ACCOUNTS PAYABLE POLICIES AND PROCEDURES

Paradise Independent School District Vendor Application

ATM Operator Application

New Case Submission Checklist Tufts Health Plan Tufts Medicare Preferred HMO Prime For Working-Aged Employees

Commercial Credit Application: Part A Account #:

Direct Deposit Setup Instructions:

NAEFCU Switch Kit. Switch Kit Checklist. Switching to NAE Federal Credit Union is easy! Three Simple Steps to Switch

Social Security/taxpayer ID number. (required by law) City State ZIP. Social Security/taxpayer ID number. City State ZIP

I m ready to make the switch.

NEW JERSEY PROVIDER AGREEMENT

Copyright 2017 Lakeland Bank. All rights reserved. This material is proprietary to and published by Lakeland Bank for the sole benefit of its

Switch Kit. A simple, step-by-step guide for switching to First Commons Bank

INFORMATION SHEET FOR GIRARD BULK SERVICE ACCOUNT PERSONAL

Virtual credit card payments

Application Forms Business Users

PART I: APPLICANT INFORMATION. Mode of Premium. Annual. Semi-Annual. Quarterly. Monthly (APP only) Medicare Claim Number.

MAKE THE SWITCH JOIN THE COMMUNITY. Make the. Switch Kit

MERCER MARKETPLACE 365 S M * RRA INSTRUCTIONAL GUIDE

APPLICATION FOR REGULAR MEMBERS

New Client Checklist (2 to 100)

All Star PREP Team Registration Form

HSBC Money Market Funds

INFORMATION SHEET FOR GIRARD BULK SERVICE ACCOUNT COMPANY

Look Inside to Find Out How... Finally, Flex is EASY & CONVENIENT! Enroll in a Flexible Spending Plan and... Give Yourself a Raise!

WSCA-NASPO Contract Commercial Card Solutions Participating Addendum Political Subdivision Addendum

1Update of Current Participant Record

**For Your Convenience We Also Accept Checks By Fax And Credit Card Payments**

Here are your Caregiver forms.

Propertyware epayments. Powered by RealPage

DTF-17-R. Application to Renew Sales Tax Certificate of Authority. Quarterly. Section A - Business information. Information in our records

(To be completed by TAS) Business Name (if applicable) FEIN: Daytime Phone: Fax: Trailer Type: (flatbed, tanker, refrigerated, box, etc:)

Checking Account Switch Kit

NOTICE. You must be a currently contracted agent/broker of Infinity Insurance Group to be eligible for enrollment in this E&O program.

Street Address (Physical Address)* Apartment # City* State* Zip Code* Mailing Address (if different from above) City State Zip Code

M O D E L R E C T I F I E R C O R P O R A T I O N 80 NEWFIELD AVENUE FAX: EDISON, NEW JERSEY USA TEL:

Transcription:

Thank You for requesting the Application for Credit with Yorkston Oil Company, Inc. There are a few things that we would like you to know before completing this application. ALL FEATURES OF THE COMMERCIAL FUELING NETWORK ARE LISTED AND EXPLAINED AT www.cfndesk.com Application for Credit: 1. If you need Help, please call 1.800.401.2201 (8am-5pm PST). 2. If you are applying for credit as a business you must include your Tax ID where noted. 3. All principals must be listed, along with SSC#. This information is required to complete your application. 4. Three (3) Credit References are required. Please be as thorough as possible when filling in blanks. 5. When including your bank reference all blanks are required. 6. Both Applicant s Signature and Guarantor s Signature are required as well as Guarantor s SSC#. On Commercial Applications, the Guarantor must be a principal of your Business. 7. Filling out this application does not guarantee an account with Yorkston Oil Company, Inc. All new accounts are established under approval of credit. Card Requirement Form: 1. It is best if you call the CFNdesk to complete this portion of the application. The Commercial Fueling Network offers an almost endless combination of security and convenience features that should be suited to your needs, please call Yorkston Oil Co. at 800.401.2201 (8am-5pm PST) ask for the CFNdesk. Authorization Agreement for Automatic Debit: 1. This feature is required for all accounts applying outside the State of Washington; however, anyone can take advantage of this option. All accounts that use this feature are given $0.05 off the price per gallon on all fuel types. This discount applies only to the Commercial Fueling Network and does not include Lubes, Furnace Oils, or Wholesale Fuels. Commonly Asked Questions: If you have any other questions, please call Yorkston Oil Co. at 800.401.2201 ask for the CFN desk. 1. Why do we need personal info about principals in our company? In the fuel business we deal with a high volume of monies, it is in our best interest to thoroughly check the credit of a company and those who own the company in order to assess the risk of issuing an account and the probability of payment. 2. Why do we need a Guarantor s Signature? Unfortunately, in this day and age, requiring a Guarantor s signature has become a necessity in doing business. 3. Why do we require an ACH Direct Withdrawal for accounts outside Washington State? We consider ourselves to be out of the area of a company who does not do business in the State of Washington.

APPLICATION FOR CREDIT FIRM NAME TAX ID ADDRESS CITY STATE ZIP PHONE FAX PREVIOUS ADDRESS (if above is less than 3 years) CITY STATE ZIP HOW LONG IN BUSINESS TYPE OF BUSINESS [ ] CORPORATION [ ] PARTNERSHIP [ ] LLC [ ] SOLE PROPRIETOR NAME OF PRINCIPLES WITH SOCIAL SECURITY NUMBERS (REQUIRED): 1. SS# 2. SS# 3. SS# CREDIT REFERENCES: NAME ADDRESS PHONE 1. 2. 3. BANK REFERENCES: 1. CONTACT: PHONE: TERMS: Lubes and Furnace Oils Net 30 days from invoice date. Furnace oils may have prearranged budget payments. Cardlock Discounts offered for 15 days prompt pay or ACH bank draft. ACH Bank Draft may be required. Wholesale ACH bank Drafts Net 3 or 5 day. A 1.5% per month service charge applies to all balances and invoices over 30 days. Account suspension takes place on accounts with balances or invoices over 30 days.

APPLICATION FOR CREDIT (CONTINUED) DISCOUNTS FOR CFN CARDLOCK ACCOUNTS: A Discount of.03 cents per gallon is given on a billing cycle if received in our office on or before due date specified on invoice. An additional.02, for a total of.05 cents per gallon, is given if you opt to use ACH Direct Debit. Your checking account will be debited on the 5 th business day from the invoice date. Your invoices and draft notification are faxed to you when invoices are generated. CREDIT LIMIT: A credit limit is set for each account. At no time will the customer be permitted to charge purchases if his (her) balance would exceed the credit limit. APPLICATION OF PAYMENTS: Payments on accounts are applied first to any charges (s), then to the invoice noted on payment or payment stub. COLLECTION COSTS: If Yorkston Oil Company, Inc. must refer this account to a lawyer or collection agency for collection, the undersigned agrees to pay collection costs, including attorney s fees and court costs. With my signature, I authorize Yorkston Oil Company, Inc. to collect bank and credit information in order to process this application. DATE APPLICANT S SIGNATURE PRINT NAME The undersigned hereby personally guarantees to Yorkston Oil Company, Inc. the full and punctual payment, and punctual payment and performance of the obligations of the named company or person. This guarantee includes all debts and obligations of the company or person, including principle, interest, collection agency fees, attorney s fees and all other obligations arising under of by reason of the extension of credit to the company or person. DATE GUARANTOR S SIGNATURE PRINT NAME SOCIAL SECURITY NUMBER *this application will not be processed if this page is not signed in both places*

CARD REQUIREMENTS FORM Need Help? Call 1-800-401-2201 Please fill in your requirements per card. Account Number (office only) CFN SECURITY FEATURES Please CIRCLE what hours, days, and number of transactions you want your driver to fuel per day. Company Name Phone Number Fax Number IMPORTANT: PLEASE NOTE YOUR CARD WILL WORK ONLY AT THE HOURS, DAYS AND NUMBER OF TRANSACTIONS SPECIFIED BELOW. You can set up your whole account with the same criteria, or you can customize each card with individual limits. Authorized Company Contact Email Address YES Please use the first card listed on this form so ALL my cards have the same security profile. Driver Name or Vehicle Description Describe each card how you would prefer it show on your billing. Vehicle Number Up to 5 digits Odometer On-Site Manual Entry For drivers to input their vehicle or employee # at time of fueling Gallon Limit State size of fuel tank Fuel Requirements You may specify one, two, three or all products per card On-Site Oil By Qt or Gal HOURS TO FUEL DAYS TO FUEL # OF TRANS- ACTIONS PER DAY 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) 12) 13) 14) 15) 16) 17) 18) 19) 20) TRANS GALS

Authorization Agreement for Automatic Debit Yorkston Oil Company, Inc. EIN# 91-1062345 I (we) hereby authorize the above named company, hereafter called the COMPANY, to initiate debit entries to my (our) account identified below and with the depository named below, hereafter called the DEPOSITORY, to debit the same said account. DEPOSITORY NAME: BRANCH: ROUTING NUMBER: ACCOUNT NUMBER: This authority is to remain in force and effect until the COMPANY and DEPOSITORY have written notification from me (us) of it s termination in such manner as to afford COMPANY and DEPOSITORY a responsible opportunity to act on it. I (we)have the right to stop payment a debit entry by notification to DEPOSITORY at least three (3) days prior to my (our) ACH debit. In case of an erroneous debit, provided I (we) supply notice to the DEPOSITORY within (60) days of receiving my (our) bank statement, the DEPOSITORY must investigate and resolve it within forty-five (45) days, but if it has not been done within ten (10) days, my (our) account will be credited for the amount in question while the DEPOSITORY finishes investigation. CUSTOMER NAME: EIN NUMBER (IF APPLICABLE): FAX NUMBER: AUTHORIZED SIGNER: AUTHORIZED SIGNER: DATE SIGNED: It is required that you attach a photocopy of a voided check from the account to be debited