Below is the on-line Personal Credit Application.

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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Applying For:
Propane:*
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Bulk Fuel:*
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Bulk Lubes:*
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BASIC INFORMATION
Name:*
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Date of Birth:*
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SSN:*
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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
Address:*
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City:*
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State:*
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ZIP:*
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Number of years at this address:*
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Phone:*
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EMPLOYER
Employer Name:*
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Employer Phone:*
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Hire Date:*
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Address:*
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City:*
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State:*
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ZIP:*
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SPOUSE
Name:*
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Date of Birth:*
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SSN:*
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SPOUSE'S EMPLOYER
Employer Name:*
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Employer Phone:*
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Hire Date:*
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Address:*
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City:*
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State:*
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ZIP:*
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GENERAL
Have you or your spouse ever filed for bankruptcy?*
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Have you or your spouse ever had a judgement entered against you? *
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Do you own your residence?*
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If you answered “NO” above, provide landlord’s name and phone number.

Landlord Name:
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Landlord Phone:
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BANK REFERENCE
Bank Name:*
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Bank Phone:*
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Address:*
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City:*
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State:*
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ZIP:*
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CREDIT REFERENCES
Reference One
Name:*
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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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Reference Two
Name:*
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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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Reference Three
Name:*
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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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PURCHASE AGREEMENT

The parties hereby agree that all purchases made are subject to the following terms and conditions:

1. All amounts due for products and services purchased from United Oil Corporation ("UOC") are payable at P.O. Box 126, Columbia City, IN 46725

2. The undersigned customer ("Customer") is liable to UOC for all products purchased and received, Whether or not Customer receives an invoice. All amounts due to UOC are payable as stated on UOC’s invoice. All past due amounts are subject to a service charge of 2% per month. Customer acknowledges UOC’s invoice may reflect a price variance between products purchased with cash, check, or electronic transfer and products purchased with a credit card.

3. In the event the account is turned over to an attorney or collection agency for collection, Customer will pay all reasonable attorneys’ fees plus all attendant collection costs whether or not suit is commenced. In the event the account is turned over to an attorney or collection agency for collection, Customer will pay all reasonable attorneys’ fees plus all attendant collection costs whether or not suit is commenced.

4. Customer will notify UOC by certified mail of any pending change of personal status and further agrees to be liable for all purchases should Customer fail to comply with said notification. Customer will notify UOC by certified mail of any pending change of personal status and further agrees to be liable for all purchases should Customer fail to comply with said notification.

5. Unless otherwise provided in a written agreement with UOC and the customer, the products and/or services purchased from UOC are not payable in installments, but payable in full per invoice. Customer agrees to provision 5 unless otherwise provided in a written agreement with UOC and the customer, the products and/or services purchased from UOC are not payable in installments, but payable in full per invoice. Customer agrees to accept liability for unauthorized use any card issued Customer, and for any attorneys’ fees incurred by UOC in collecting unauthorized debts, even if the liabilities exceed the thresholds established in the federal law, 15 U.S.C. 1643.

6. Release of credit information: Customer authorizes UOC to inquire info and obtain from any bank, lending institution, or credit reference, whether listed on Customer’s credit application or not, any and all information relating to Customer’s credit worthiness or financial condition.

7. All disputes that may arise out of the Agreement will be within the exclusive jurisdiction of and will be resolved under the laws of the State of Indiana. Venue shall be in Whitley County, Indiana. All disputes that may arise out of the Agreement will be within the exclusive jurisdiction of and will be resolved under the laws of the State of Indiana. Venue shall be in Whitley County, Indiana.

8. This Agreement may be executed simultaneously in any number of counterparts, each of which shall be deemed an original and all of which shall constitute one and the same instrument. Signed signature pages may be. This Agreement may be executed simultaneously in any number of counterparts, each of which shall be deemed an original and all of which shall constitute one and the same instrument. Signed signature pages may be transmitted by facsimile or electronic means, and any facsimile, electronic, or photocopy signature shall have the same effect as an original and shall be equally enforceable in a court of law.

9. Option to Waive: UOC may, at its option, waive any of its requirements, or excuse Customer’s non-compliance with any of its obligations. However, any such waiver or excuse shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent UOC from declaring a breach or non-compliance by Customer, either of the same term or otherwise.

10. Returned goods will not be accepted without prior authorization. Some returned or special-order goods may be subject to a restocking fee.

11. All returned checks or electronic payments are subject to a $35.00 fee.

12. UOC may terminate this Agreement or the rights granted hereunder upon oral or written notice to Customer, and may revoke credit/charge privileges for any reason at UOC’s sole discretion.

13. United Oil Corporation and its affiliates have the ability to contact you via e-mail, phone, mail, or facsimile regarding, but not limited to invoicing, scheduling, promotions, etc.


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


DIGITAL SIGNATURE
Signature:*
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Date:*
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