Customer Information


Spouse Information


Last Supplier Information

Acquisition Information

Delivery Method


*Automatic (Recommended Option): We will estimate your oil usage and will automatically fill your tank when needed, giving you the peace of mind of never running out of heating oil.
**Will Call: Customer monitors their oil tank status and calls Eastern Fuel when an oil delivery is needed. Must give notice of 2 business days. Customer will be responsible for run out charges.

Other Services

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Terms and Conditions

DO NOT SUBMIT THIS FORM BEFORE YOU READ THE TERMS AND CONDITIONS AGREEMENT

  • YOU ARE ENTITLED TO A COPY OF THIS AGREEMENT AND THE INFORMATION REGARDING YOUR RIGHTS DISPUTE BILLING ERRORS. BUYER(S) HEREBY ACKNOWLEDGES RECEIPT OF A TRUE COPY OF THIS CREDIT AGREEMENT AND BILLING ERRORS INFORMATION.
  • I HEREBY AUTHORIZE YOU OR ANY CREDIT REPORTING AGENCY EMPLOYED BY YOU TO INVESTIGATE THE REFERENCES HEREIN LISTED OR ANY OF THE OTHER INFORMATION STATED ABOVE TO DETERMINE MY QUALIFICATIONS FOR A CREDIT ACCOUNT.
  • TERMS: NEXT 10 DAYS FROM DELIVERY DATE. PAST DUE ACCOUNTS WILL BE SUBJECT TO 1 1/2 % MONTHLY SERVICE CHARGE WHICH IS AN ANNUAL PERCENTAGE RATE OF 18% ACCOUNTS 31 DAYS AND OVER WILL BE TEMPORARILY DISCONTINUED UNTIL ACCOUNT IS CURRENT, UNLESS SATISFACTORY ARRANGEMENTS ARE MADE. IN EVENT OF DEFAULT, THE APPLICANT WILL BE LIABLE FOR ANY AND ALL COURT AND ATTORNEY FEES AS ALLOWED BY LAW.
  • By submiting this form I authorize Eastern Fuel Corporation or its assigns to make deliveries of home heating oil and/or provide equipment service to my premises listed on this form. Such service shall begin after this application has been processed and approved by Eastern Fuel. Deliveries shall be and remain on an automatic basis unless indicated. This agreement shall be valid and active until it is cancelled in writing.