Credit Application

TO SIGN UP FOR Automatic Delivery you must fill out our CREDIT Application:




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Name (First, MI, Last)(*)

Please provide us with your name



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Co-Applicant's Name: (First, MI, Last)

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MAILING ADDRESS INFORMATION:


Your Address: (City, State, ZIP)(*)

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Phone (Night)(*)

Please provide us with your phone number

Phone (Day)(*)

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Phone (Delivery)(*)

Please provide us with your phone number

Email(*)

Please provide us with your email address

Do you own your own home?

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For how many years

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Name of person or organization that referred you to us:

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LANDLORD INFORMATION:
If you rent, please complete landlord's information




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Name (First, MI, Last)(*)

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Landlord's Address: (City, State, ZIP)(*)

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Your Previous Address: (City, State, ZIP)(*)

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DELIVERY INFORMATION


I need

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Former Fule Supplier(*)

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Date of Last Delivery


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Delivery Type(*)

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Delivery Address: (City, State, ZIP)(*)

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Nearest Cross Street

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Fill Pipe Location

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Tank Size (in gallons)(*)

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Oil Type(*)

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Annual Usage(*)

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Burner Brand

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Do you use oil to heat your hot water?

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Delivering

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CREDIT INFORMATION


Social Security No: (Applicant)(*)

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Social Security No: (Co-Applicant)

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Employers Name(*)

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Bank Name(*)

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Bank Address (City, State, ZIP)(*)

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Checking Account Number(*)

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Savings Account Number

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I authorize Reichert Oil to check my credit rating. Your Name:(*)

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NOTICE: If we refer your account to collection, your account will increase by 25%. In the event your account is referred to an attorney, you will pay lawyer's fees of 25% of the total unpaid balance in addition to any costs incurred.


Please check the box(*)

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Office Hours

Main Office Hours:
Monday - Friday: 9am to 5pm
Saturday: 9am to 4pm
Closed Sundays/Holidays

Call Center: 24/7

Office Locations

  • Reichert Home and Commercial Heating Oil

    Reichert & Sons Oil Company

    210 Old Snake Hill Rd
    Chepachet, RI 02814

Interested or Questions?
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