Credit Application
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675-FUEL
1-888-377-FUEL
Credit Application For a
Residential Heating Oil Account
Please note that your personal information will be used for the sole purpose of a check with the Credit Bureau to establish a fuel account with Perfect Source Fuels & Mechanical.  It will not be shared with any other party for any other reason.  At Perfect Source Fuels & Mechanical we respect your privacy.  Accounts are subject to credit approval.  Payments are due by the 30th of each month.  Overdue accounts will be charged 2% interest per month.  Fuel will not be delivered to over due accounts.
Name:  required field
Street & Number: required field
City: required field Postal Code: required field Phone #: required field
Mailing Address (if different than above):
City: Postal Code: Phone #:

This information is not required if the customer wishes to pay cash or cheque at the time of delivery.
Date of Birth: S.I.N. (optional):
Employer:   Occupation:
Employer's Phone #: Length of time with current employer:  
Previous employer if less than 3 years:
Bank: Account number:
Do you own or rent your home: (please check one)       Own      Rent

Delivery Information:
Tank Size: required fieldLiters  Gallons required field Location of fill pipe:  Left  Right  Front  Back required field
Can we use the driveway:    Yes        No required field Oil Hot Water Tank    Yes        No required field
Delivery Method: (Please check one)      Automatic             Requested required field
Automatic Delivery:  Perfect Source delivers on a regular schedule, no customer action required.
Requested Delivery:  Perfect Source only delivers when the customer calls.  Minimum five (5) business days notice are required for delivery.  Customers must keep track of their own oil supply.

System Information:         Forced Air           Hydronic (Boiler and Water) required field
If Hydronic (please check one)         Rads     Fan Coil     Radiant     Other
System Age: (approximate) required fieldDate of last cleaning: required field
Does you home have:              Central Air Conditioning         Heat Recovery Ventilation
Are you interested in furnace / boiler insurance?                   Yes     No     Not Sure required field
Are you interested in monthly equal billing?                            Yes     No     Not Sure required field
Would you like more information on indoor air quality?        Yes     No     Not Sure required field









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