TX Residential & Commercial Credit Application

Residential Credit Application

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Applying as..(Required)

Individual

Couple

Name(Required)

First Last

Home Phone

Cell Phone(Required)

Email(Required)

TX Driver's License Number(Required)

Date of Birth(Required)

Physical Address(Required)

Street Address Address Line 2 City State ZIP Code

Billing Address (if different than physical address)

Street Address Address Line 2 City State ZIP Code

Are you currently employed?(Required)

Yes

Employer(Required)

Employer Address(Required)

Street Address Address Line 2 City State ZIP Code

Employer Phone(Required)

Spouse's Information

Name(Required)

First Last

Email(Required)

Phone(Required)

TX Driver's License Number

Date of Birth(Required)

Is your spouse currently employed?(Required)(Required)

Yes

Employer(Required)

Employer Address(Required)

Street Address Address Line 2 City State ZIP Code

Employer Phone(Required)

Personal References

Relative or person you have known for over one year.

Reference 1(Required)

First Last

Reference 1 Phone(Required)

Reference 1 Relationship(Required)

Reference 2

First Last

Reference 2 Phone

Reference 2 Relationship

Terms

In consideration of Baygas Propane, acceptance of the credit of the undersigned and allowing merchandise (both goods and services) to be charged to the applicant(s)’ charge account under this agreement, the undersigned agrees as follows:

All payments are payable at the office of BAYGAS PROPANE, 2694 Calder Drive, League City, Texas 77573.
All past due amounts shall bear interest at the rate of 18% per annum and/or late fee of 10%.
If the unpaid balance of this account is referred to an attorney or judge for collection, applicant(s) agree to pay reasonable attorneys’ fees, court costs, and any other disbursements incurred in such collections.
Payment terms are Net 10 upon receipt of invoice.
This Agreement will remain in effect until written notice of its cancellation is delivered to BAYGAS PROPANE at its principal office address. However, it is agreed that the undersigned will remain liable under this agreement for payment of any charges incurred prior to the date of the delivery of any such notice of cancellation.

Consent(Required)

I have read and understand the general terms and conditions of sale for Baygas Propane(Required)

Signature(Required)

Date(Required)

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Commercial Credit Application

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Company Name(Required)

Phone(Required)

Fax

Email(Required)

Billing Address(Required)

Street Address Address Line 2 City State ZIP Code

Delivery Address (if different than billing address)

Street Address Address Line 2 City State ZIP Code

Type of Business(Required)

Sole Proprietorship

Partnership

Corporation

Name of Owner or Partner(Required)

First Last

Owner or Partner Phone(Required)

Owner or Partner Address

Street Address Address Line 2 City State ZIP Code

Corporation Information

Date of Incorporation(Required)

State of Incorporation(Required)

State

Registered Agent Name(Required)

First Last

Registered Agent Phone

Registered Agent Address

Street Address Address Line 2 City State ZIP Code

Officers

Name

Title

Phone

Home Address

Terms

I release and waive all claims or liabilities against the references I have listed above or its employees which arise out of, or are in any way connected with, the release of credit information to which I have consented.

CHARGE ACCOUNT POLICY: Payment due by the 10th day of the month. A 10% late fee will be assessed after 30 days. All accounts that are over 45 days will be removed from the charge list and put on the COD ONLY list. At 60 days, all accounts that are past due will be turned over for collection. If the account has a lease tank and is over 60 days past due, the tank will be picked up and any remaining product will be lost.

DISCREPANCIES: All billing errors must be reported to BAYGAS PROPANE in writing no later than 5 days from the date of the statement. If an employee is no longer authorized to charge on the account, you must notify Baygas Propane in writing as soon as possible or you will be responsible for all charges.

Consent(Required)

I have read and understand the gernal terms and conditions of sale for Baygas Propane(Required)

Signature(Required)

Date(Required)

CAPTCHA

Residential & Commercial Credit Applications for Baygas Propane

Apply for Credit

Residential Credit Application

Spouse's Information

Personal References

Terms

Commercial Credit Application

Corporation Information

Terms

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