Personal Info

Mailing Address

Physical Address

Same As Mailing Address

Own
Rent

Delivery Address

Same As Mailing Address
Same As Physical Address

Contact Info

Products Needed

Fuels (Diesels, Gases, Home Heat)
Propane
Lubricants

Intended Usage

Primary Home Heat
Secondary Home Heat
Garage/Outbuilding
Water Heater
Cooking
Fireplace
Pool
Other

Tanks

I own my tank
I would like to lease a tank
I would like to purchase a tank

How did you hear of us?

Michlig Employee
Family/Friend
Website
Advertisement
Other

Financial Info

Employment Info

Credit References

List obligations such as Finance Companies, Utility Companies, Etc.

Terms of Service

I agree that the following terms will govern any purchases made which are charged to any account that I may have with Michlig Energy, Ltd.

1. I will pay the entire balance according to my account terms. (Discounts may be offered on certain bulk product purchases bases on the marketing program.)
2. I understand that a FINANCE CHARGE of 1.50% (an annual rate of 18.0% per year) will be applied to that part of any balance not paid before the last billing day of the following month plus any previous balance that remained unpaid.
3. Payments shall be applied first to the unpaid FINANCE CHARGE, then to the remaining outstanding balance.
4. In the event that collection proceedings must be instituted to collect any balance due, I will be subject to a collection fee have up to 30% of the balance due and/or court costs.
5. If applying for a joint account, both of us agree to be bound by the terms of this agreement and each of us agree to be jointly and severely liable for payment of all purchases made.
6. Accounts that reach 60 days past due shall be deemed cash only. The company at its option may limit or terminate charge privileges at any time. I, the undersigned, agree to the terms of Michlig Energy, Ltd. credit policy. I request credit to be extended to me under these terms and agree to act and remit in accordance. I further understand that by signing this application, Michlig Energy, Ltd is not bound to extend credit. I authorize by my signature below, any employer, financial institution, or other creditors that may or may not appear on record to release information pertaining to my credit.

Your Signature *

Submission will be dated November 21st, 2024

Spouse's Signature

Submission will be dated November 21st, 2024