CREDIT APPLICATION

Privacy Policy: Information gathered from this Credit Application will be used exclusively by Easy Fuel, Inc. for the sole purposes of conducting transactions between customer and Easy Fuel, Inc. Easy Fuel, Inc will not disclose information gathered from this credit application to any third parties, including affiliates, except as permitted by law.

Download Printable Application (PDF - 95 KB)

Download Electronic Application (MS Word- 104 KB)

Date Business Started: *
Company Name: *
	Tel	Fax
Address: *
	Street/P.O. Box
	City
	State
	Zip
Line of Credit Requested: *
Names of Partners , Owners or Officers *
Name:	Title:
Trade References:*
Name:	Address:		Fax:
Bank Information: *
Bank/Branch:	Account #:		Fax:
Authorization: *
Date: *
Signature (initials): *
Title: