Become A Customer

Start Your Journey with us

(914) 945-0645

customerservice@palisadesfuel.com

68 S Highland Ave
Ossining, NY 10562

CUSTOMER AUTOMATIC DELIVERY APPLICATION

Complete the Form Below to Become a Customer

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Step 1 of 2

This field is for validation purposes and should be left unchanged.

Name*

Rent or Own?*

Address*

Use of heating oil*

Email*

Phone*

Type of delivery*

Fuel tank size*

Type of fuel tank*

Credit Card #*

Fill location (facing house)*

Credit card type*

Exp. date*

Delivery directions/instructions:*

Signature (Please type first and last name)*

Name of employer*

# of years*

We will need the last 2 oil delivery dates, and the amount of gallons. If you do not have this information, we at Palisades Fuel will schedule your next 2 deliveries to get the proper calculation.*

Please enter your last two oil delivery dates and amount of gallons above.

CREDIT TERMS: Automatic delivery customers require a credit card guarantee. Palisades Fuel invoices must be paid within 10 days. Automatic delivery can only be canceled upon written request to our office. If your balance is not paid, we reserve the right to bill any credit card on file without notification. If you have a balance on your account, and your credit card is denied, you will not receive a second delivery. Regardless of whether or not this application is approved, I agree (1) to remit all payments within 30 days of delivery. Also, I understand and agree to pay a late charge in each instance a payment is not received when due (all late charges will be computed as follows: 1-1/2% per month (ANNUAL PERCENTAGE RATE 18%) applied to balances remaining unpaid over 30 days past invoice date): (2) I understand and agree to pay a service charge if a check is tendered in payment and that check is returned to you unpaid for any reason: and (3) I understand and agree to pay all costs incurred by you in collecting my account including attorney fees up to 33-1/3% of the amount referred for collection. If any suit needs to be filed to collect an unpaid balance, customer agrees that such may be brought in the courts of Westchester County, State of New York. I understand if approved by you, I may elect to participate in the budget payment plan. If I elect to participate in this plan, I agree to settle my account in full each June. In the event I change my address, I agree to provide you a minimum of two weeks notice in writing. I understand that I am responsible for the payment of all my products and/or services provided by you to my address until such time as this notice is received by you.*

I would like to sign up for the following service contract:*

*Please include payment. You must be automatic delivery to purchase our Platinum Service Agreement. Upon renewal, your account will be automatically billed for the subsequent contract period.

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