Account Application

Main Information

Personal Information

Employment Information

The CUSTOMER HEREBY REQUESTS CREDIT FROM MACGILLIVRAY FUELS FOR THE PURCHASE OF FUEL OIL. The customer is notified that a report as to credit and other information is to be obtained for credit now applied for and any transaction from hme to time related thereto. The customer acknowledges and consents to the disclosure of any credit or personal information in the possession ol MACGILLIVRAY FUELS to any credit grantor or consumer reporting agency with whom MACGILLIVRAY FUELS may transact.

Printing your name here constitutes a signature for the purposes of this application