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Residential Heating Oil Account Application
In order to establish an account with Capitol Di$count Fuel, you must fill out the form below to apply for an account.  You will receive an email confirmation at the email address you provide and the Customer Service staff will contact you shortly.

* Required field
Contact Information
First Name*
 
Last Name*
 
Email Address*
   
Confirm Email Address*
     
Social Security #: *
 
 
Address*
 
Address 2
City*
 
State*
 
Zip Code*
   
County
Home Phone (10 digits only, no hyphens)*
   
Work Phone
 
Cell Phone*
   
Home Ownership
How long at this address?*
 
Former Address, City, State, Zip*
 
 
Employment Information (optional)
Employer
How Long?
Employer's Address
 
Spouse Information (optional)
Spouse Name
Spouse Employer
Spouse Address
Spouse Phone


Spouse Social Security #

 
Payment and Delivery Information
Payment Type - Check One
In what format would you like your bill/invoice? Check One
Delivery Type - Check One
Tank Size
Tank Location
Heat Hot Water with Oil
 
Special Instructions for Deliveries
Describe Location of Fill Pipe* (if facing front of home)
 


Credit Policy and Terms

  1. Payments are due upon receipt of invoice.
  2. A late charge may be assessed on all balances over thirty (30) days. This is computed by a periodic rate of 1.5% (which is an annual percentage of 18%) on the portion of the previous balance over thirty (30) days less payments and credits appearing on the statement. An account is considered past due when a late payment charged is assessed.
  3. Any account which becomes past due is subject to termination of automatic fuel delivery without notice until the account balance is paid in full.
  4. All fuel remains the property of Capitol Di$count Fuel until paid in full.  Capitol Di$count Fuel reserves the right to reclaim any fuel not paid in full.
  5. Should past due account(s) require the assistance of a collection agency and/or attorney to obtain payment(s), the credit applicant herein agrees to pay for all costs, including any attorney's fees associated with collection and any subsequent enforcement action.
  6. A service charge of $25.00 will be added on any check returned by a bank.
  7. Any out of fuel resulting from non-payment will incur a start-up fee upon delivery.
  8. Termination of automatic delivery service must be made in writing.
  9. I hereby authorize you or any credit reporting agency employed by you to investigate the references herein listed or any of the other information stated above to determine my qualifications for a credit account, I also acknowledge receipt of a true copy of the credit terms listed.