Commercial Credit Application

Fill out and SUBMIT or Print and send to doyle@legacypropanellc.com

Company Name:*

Phone Number:*

Fax Number:

E-mail:*

Fed ID Number:

Company Address:*

City,State,Zip:*

Owner's Name:*

Yrs in Business:*

Owners Home Phone:*

Owner's Address:*

City,State,Zip:*

Owner's SSN:*

Owner's Drivers License:*

Name of Bank:

Checking Account#:

Bank Address:

City,State,Zip:

Bank Phone#:

Business References

Company:

Phone:

Address:

City,State,Zip:

Company:

Phone:

Address:

City,State,Zip:

Company:

Phone:

Address:

City,State,Zip:

This information must be provided to open an account with Legacy Propane. The information provided will be used only for credit evaluation purposes. Legacy Propane credit terms will be determined on an individual basis. Finance charges are computed at a rate of 1.5% per month or 18% per year on past due balances. I hereby agree that in the event of default in the payment of any amount due, and if this account is placed in the hands of a collection agency or attorney for collection or legal action, to pay an additional charge equal to the cost of collection including collection agency and attorney fees and court costs incurred.