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Credit Applicaton

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Credit Applicaton

Credit Applicaton

Looking to open a line of credit with Husky?

Use our Husky Heating Oil credit application to get started. One of our associates will contact you to complete the process.

Step 1 of 4

25%

Credit Application
Name*
First Last
Date of Birth*
MM
DD
YYYY
Home Phone*
Mobile Phone
Work Phone*
Email*
Are you currently employed?*
- Yes
- No
Employer's Name

Delivery Information
Address*
Street Address Address Line 2 City State ZIP Code
Billing Address
Street Address Address Line 2 City State ZIP Code

If different from Delivery Address

Oil Tank and Home Information
Do you:
- Own your home
- Rent your home
Tank Size:
Location of your tank:
Gallons in Tank today:
Annual Consumption:
Approx. Home Size (sq feet)
Number of bedrooms:
Is oil used to heat water?*
- Yes
- No
Is the basement heated by oil?*
- Yes
- No
Are there any infants or elderly individuals in your household?*
- Yes
- No
Additional Information (i.e. heated pool, 2 tanks, 2 fills, oil is backup heat)
Service Type Requested*

Credit Card Authorization
Below is our Credit Card Charge Agreement. This will be kept on file and ONLY used for any past due balance or invoices - and is required. By completing this form, you agree to give HUSKY HEATING OIL COMPANY AUTHORIZATION TO CHARGE YOUR CREDIT CARD LISTED BELOW FOR ANY PAST DUE BALANCE OR INVOICE.
Name as it appears on Card
Card type:
Card Number*
Expiration Date*
Date Format: MM slash DD slash YYYY
CVC Number*

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Phone:

410-418-8000

Find Us at:

Husky Heating Oil, LLC
9121 Red Branch Road
Columbia, MD 21045

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