Below is the on-line Electronic Funds Transfer Authorization. Complete this form if you would like to make your payments automatically by allowing United Oil Corp to debit your checking account directly.

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 ELECTRONIC FUNDS TRANSFER (EFT) AUTHORIZATION comodo secure 76x26 white

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

 

Name:*
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E-Mail:*
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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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PHYSICAL ADDRESS
Street Address*
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City:*
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State:*
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ZIP:*
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We hereby authorize United Oil Corporation and each of its successors and assigns to initiate debit entries to our checking account indicated below and the depository named below (hereinafter called "Depository") to debit the same to such account. I (we) acknowledge that the origination of ACH transactions to my (our) account must comply with the provisions of U.S. Law. This is a binding agreement that may be executed by facsimile.

Bank Name:*
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Bank Telephone:*
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ABA (Routing) Number (9 digits):*
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Account Number:*
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Having trouble finding these numbers? See the sample check image below.

This EFT agreement is to remain in full force and effect until United Oil Corporation and the Depository have received written notification from us in such time and manner as to afford UOC and the Depository a reasonable opportunity to act on the notification. This agreement allows UOC to charge debits to this account at frequent intervals for varying amounts.

Legal Name:*
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Contact:*
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Phone:*
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Fax:
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By signing the below you are agreeing to all of the terms and conditions stated above.

DIGITAL SIGNATURE
Electronic Signature:*
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Date:*
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Information entered in this form is encrypted and transmitted over a secure connection to United Oil Corporation.