Oil Delivery Sign Up - State Line Propane & Oil

Account Type *

Name *

First

Last

Delivery Address *

Address Line 1

Address Line 2

City

State

Zip Code

Billing Address - Only needed if the address is different from the Delivery Address

Address Line 1

Address Line 2

City

State

Zip Code

Primary Phone Number *

Alternate Phone Number

Email *

Invoice / Statement Preference *

Home / Building Style *

IE: Colonial, Ranch, Cape, Commercial

Home / Building Square Footage *

Primary Color of the Building *

Accent Color

Move In or Purchase Date

Heating Oil Usage *

Please select all the equipment heating oil is used for in your home or building.

Number of Tanks *

How many oil tanks are onsite?

Tank Size *

What is the size of the tank or tanks

Is the Tank Underground? *

Fill Location - Standing outside looking at the front of the home or building where are the tank / tanks located? *

Choose all that apply

Current Heating Oil Supplier?

Special Instructions or Requests?

Oil Delivery Service Type *

How did you hear about us?

Welcome! We’re excited your here to join us.