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

Residential Credit Application


Address Information
Title Full Name
Address City
Province Postal Code
Years at Address SIN
Same Delivery Address Email

Delivery Address
Address City
Province Postal Code

Former Address
Address City
Province Postal Code

More Information
# Rooms to be heated Fuel Tank Size
Tank Location Approx. Fuel Currently in Tank Former Fuel Supplier
Type of Fuel Required
Date of Birth Marital Status Spouse Name
Home Phone Work Phone    

Employment
Employed By Address
Position NO. of Years
Previous Employer If Less Than 1 Year
Address
No. Of Years
Position
Spouse's Employer (if applicable)
Address
No. Of Years
Position

References
Bank Address
Account No. Type
Bank Credit Card 1 Account No.
Bank Credit Card 2 Account No.
Bank Credit Card 3 Account No.
Other (Personal If Desired)

Final Details
Delivery Schedule
Furnace Protection Plan
Preferred Payment Plan
 
 
Account Information
Institution
Transit
Account

Terms of Service