Upper Canada Fuel & Burner.

24 Hour Emergency Service - All Types of Burners - Oil - Gas - Propane.
Phone - 1-705-742-8815 or Toll Free 1-800-461-6412

Commercial Credit Application


Please complete credit application fully. It is understood that the information given in this application is complete and accurate. Authority is granted to Upper Canada Fuels to verify credit with reporting agencies, credit references and other sources disclosed herein to adjudicate Credit Terms.

Your Company
Name Operating As
Address City
Province Postal Code
Telephone Fax
Accounts Payable Contract Purchase Order Required
Tax Exempt Principals Name & Title
Nature of Business In Business Since
Same Delivery Address Email

Delivery Address
Address City
Province Postal Code

Individual or Partnership
Full Name Date of Birth
Address City
Province Postal Code
Telephone Fax
S.I.N. #    

Banking Information
Bank Branch
City Account #

References
Name Address Telephone
1)
2)
3)

Product Requirements
 

Credit Requested
Monthly Purchases Cardlock Required
Number of Cards P.I.N.
Unless specified otherwise, the same P.I.N. will be used for all cards. The customer hereby certifies that the information provided to Upper Canada Fuels is true and agrees to abide and be bound by the terms set out in this application. The applicant acknowledges and agrees to credit responsibility for all purchases on the account as outlined in the credit terms.
Notes:

Terms of Service