CUSTOMER CREDIT APPLICATION & PROPANE ACCOUNT SETUP FORM
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PRIMARY APPLICANT INFORMATION

Primary Applicant Name
Primary Applicant Current Address

PRIMARY APPLICANT EMPLOYMENT

Primary Applicant Employer Address

PRIMARY APPLICANT FINANCIAL REFERENCES

IMPORTANT NOTICE TO CUSTOMER
1. The information supplied is accurate as of the date shown; 2. An investigation of all statements or other credit data herein and release of such information to DCC Propane, LLC or any of its subsidiaries, from any and all sources is authorized; 3. A release is granted to all parties from all liability for any damage that may result from furnishing information to you; 4. To recognize that your individual credit history may be a factor in the evaluation of this credit application; and, 5. Consent to and authorize the use of any external credit reporting information utilized by DCC Propane, LLC or any of its subsidiaries, from time to time as may be needed.
Clear Signature
Date / Time

CO-APPLICANT INFORMATION

All fields below are required to have a co-applicant on the account.

Co-Applicant Name
Co-Applicant Employer Address
IMPORTANT NOTICE TO CUSTOMER - Co-Applicant
1. The information supplied is accurate as of the date shown; 2. An investigation of all statements or other credit data herein and release of such information to DCC Propane, LLC or any of its subsidiaries, from any and all sources is authorized; 3. A release is granted to all parties from all liability for any damage that may result from furnishing information to you; 4. To recognize that your individual credit history may be a factor in the evaluation of this credit application; and, 5. Consent to and authorize the use of any external credit reporting information utilized by DCC Propane, LLC or any of its subsidiaries, from time to time as may be needed.
Clear Signature
Co-Applicant Signature Date / Time

Tank LeaseWe can provide on-site storage equipment starting as small as 125-gallons right up to configurations supplying thousands of gallons of on-site fuel storage. 

Easy Online PaymentsSign up for online account access. You can view your invoice, pay online and review your service history.

Tank Switch OutLeasing a tank from another provider? No Problem. We switch out your old tank for a new one, move any propane you may have already paid for and call your previous provider to have them pick up the old tank!

Remote Tank MonitoringFor added convenience, we offer wireless tank monitoring systems. Your tank “phones home” so we always know when you need propane and schedule your deliveries accordingly.