Below is the on-line Credit Application for a Commercial Customer.

If you prefer not to apply on line, Click here for a fillable PDF application that can be e-mailed or mailed to United Oil Corporation. Download the Application to your computer and fill it out in Adobe Acrobat Reader. You can then e-mail the completed form to This email address is being protected from spambots. You need JavaScript enabled to view it.. Or mail it to United Oil Corp.

ON-LINE PERSONAL CREDIT APPLICATION comodo secure 76x26 white

Information entered in this form is encrypted and transmitted over a secure connection to United Oil Corporation.

 

Your Name:*
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Your Email:*
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BUSINESS INFORMATION


Business Type:*
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Business Name:*
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BILLING ADDRESS


Address:*
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City:*
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State:*
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ZIP:*
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DELIVERY ADDRESS


Address:*
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City:*
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State:*
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ZIP:*
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Phone:*
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Fax:
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IN BUSINESS SINCE

Month:*
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Year:*
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FEDERAL ID NUMBER:*
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BANK REFERENCE


Bank Name:*
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Account Number:*
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Address:*
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City:*
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State:*
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ZIP:*
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TRADE REFERENCE


Reference One
Name:*
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Account Number:*
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Address:*
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City:*
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State:*
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ZIP:*
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Phone:*
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Fax:
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Reference Two
Name:*
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Account Number:*
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Address:*
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City:*
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State:*
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ZIP:*
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Phone:*
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Fax:
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Reference Three

Name:*
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Account Number:*
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Address:*
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City:*
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State:*
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ZIP:*
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Phone:*
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Fax:
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CREDIT REQUEST


CREDIT LINE YOU ARE REQUESTING FOR MONTHLY CHARGES $*
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PARTNERS OR OFFICERS


Owner/Partner/Officer One
Name:*
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SSN:*
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Address:*
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City:*
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State:*
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ZIP:*
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Owner/Partner/Officer Two
Name:*
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SSN:*
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Address:*
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City:*
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State:*
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ZIP:*
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PURCHASE AGREEMENT

It is agreed that if payment is not received when due and if it is placed with an attorney, certified collection agency, or other avenue of collection, for collection that the undersigned guarantor(s) agrees to pay to you all costs of collection, including a sum equivalent to one-third (1/3) of the amount referred to such collection agency or attorney, which the undersigned guarantor(s) agrees to be just and reasonable, or any court having jurisdiction shall determine to be just and reasonable, which shall immediately be added to the amount due. This guarantee may not be waived orally and shall continue in full force and effect until such a time when you shall receive from the undersigned written revocation and such revocation shall not in any way relieve the undersigned from liability for indebtedness incurred prior to the actual receipt by you at your office of such notice. Said notice should be sent certified mail with return receipt and the signed registry return receipt card shall be the best evidence thereof. The undersigned party agrees that all transactions are governed by the State of Indiana, the county of Whitley. Whitley County, in the State of Indiana, shall be the venue of any court proceedings in relation to collection of debt.

It is also understood that for value received and the further consideration of any credit that you may extend to the premises mentioned in this agreement, the undersigned does (do) hereby guarantee the full prompt payment to you of all indebtedness which the said person or corporation has hereto incurred or does hereafter incur for the purchase of merchandise or services from United Oil Corporation or its authorized agent or representative.

ALL ACCOUNTS WITH A BALANCE OVER THIRTY DAYS WILL BE ASSESSED A SERVICE CHARGE EQUAL TO 2.0% PER MONTH, AT AN ANNUAL RATE OF 24% A.P.R.

United Oil Corporation and its affiliates have the ability to contact you via e-mail, phone, mail, or facsimile regarding, but no limited to invoicing, scheduling, promotions, etc.

I (We) hereby certify that I (we) have read this form in its entirety and accept its conditions, and further state all information supplied by the undersigned is true in fact and intent.



By signing the below you are agreeing to all of the terms and conditions stated above.

SIGNATURE SECTION


Corporate Name:*
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Officer:*
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Applicant:*
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Signature Date:*
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Information entered in this form is encrypted and transmitted over a secure connection to United Oil Corporation.