Smith & Sons Fuels Automatic Delivery App

Smith & Sons Fuels
AUTOMATIC DELIVERY APPLICATION

ONLY COMPLETE THIS FORM IF YOU WANT DELIVERIES AUTOMATICALLY EACH MONTH to occur SEPTEMBER - APRIL WHEN WE ARE IN YOUR AREA
CREDIT/DEBIT CARD OR ACH CHECKING ACCOUNT MUST BE ON FILE FOR BILLING
CONTRACT RENEWS ANNUALLY, UNLESS CANCELLED IN WRITING
Click here for complete list of Important Auto Delivery Terms

* Indicates required field

AUTO Primary Name on Account *

First

Last

AUTO Email *

AUTO Primary Number *

Secondary Number *

Physical Address *

Line 1

Line 2

City

State

Zip Code

Country

Is this service address a business? *

YES NO

Mailing Address (if different) *

Line 1

Line 2

City

State

Zip Code

Country

If this address is a business ... Is this business tax exempt? *

NOT APPLICABLE YES NO

If the service address is for a business we are required to charge tax on your order unless a tax exempt certificate is submitted to our office.
Please be sure to submit the certificate upon completion of your automatic application.
You can submit the form by dropping it off or mailing it to the office or also emailing us at smithandsonsfuel@gmail.com

Delivery Instructions; House description; Fill pipe location; any other necessary information *

Emergency Contact Name & Phone *

Number of tanks at house *

Square footage of home *

Average Annual Usage (gallons) must =500+ annually to qualify *

Product *

Regular ULS Home Heating Oil (inside tanks) Kerosene (outside tanks) 50/50 Blend

Do you have an additional heat source that is used regularly? *

Do you rent this out on airbnb or vrbo? *

Do you use oil for hot water *

YES NO

**If yes, do you require a monthly delivery year round instead of Sept-April *

YES NO Not applicable

Do you live in the home year round *

YES NO

**If no, do you want delivery every 2 months instead of each month? *

YES NO Not applicable

*Automatic deliveries are scheduled every 4 weeks September-April.
Based on your previous annual usage you can request a delivery every 3 weeks, November-March.
(Pick yes if you have previously used over 200+ gallons in one month)

Would you like a delivery every 3 weeks? *

YES NO Not applicable

What date would you like your first automatic delivery? Please note May-Labor Day all deliveries are done on Fridays. During the heating season they are done on zone dates listed under "Delivery Areas". *

Payment Method Type *

Credit Card Electronic Check (ACH)

**Call the office to put your credit card/banking information on file**
For security purposes we ask that you do not transmit this information by email

Effective 9/2024 5 cent cash discount automatically applies if you pay for your deliveries using your ACH (e-check).
Complete & remit the ACH authorization form. Verbal authorization can not be accepted.

TERMS:

I understand that it is my responsibility to make sure my tank, whistle and pipes are in good working order prior to delivery.
I understand that if I change my hot water source or 2nd heat source I need to contact Smith & Sons so they can adjust my deliveries accordingly
I understand that if I need to make changes to my automatic delivery account I will need to notify the office by completing the Automatic Delivery Change form
I understand that prices vary based on market conditions
I understand that I must have a credit card/ACH account on file to be charged after every delivery
I understand that my driveway must be plowed & sanded and a clear path to the fill pipe is required for safety and liability of our delivery drivers

I understand the terms as stated above and have read the additional important Auto Delivery Terms page *

YES

Click here for complete list of Important Auto Delivery Terms

Submit

If you would like us to deliver once a month September-April please complete this form. We will come year after year unless cancelled in writing.

CLICK HERE TO MAKE CHANGES TO YOUR EXISTING AUTOMATIC FUEL DELIVERY ACCOUNT

Smith & Sons FuelsAUTOMATIC DELIVERY APPLICATION

Smith & Sons Fuels
AUTOMATIC DELIVERY APPLICATION