Owners or partners names
Partner 1:	First Name: M.I. Last Name:
Title:	% owned:
Drivers License #
SSN#:
Residential Addresses for Past 5 Years	Address: City: State: Zip:
Business Addresses for Past 5 Years	Address: City: State: Zip:
Fictitious Business Name(s) Used previously
Partner 2:	First Name: M.I. Last Name:
Title:	% owned:
Drivers License #
SSN#:
Residential Addresses for Past 5 Years	Address: City: State: Zip:
Business Addresses for Past 5 Years	Address: City: State: Zip:
Fictitious Business Name(s) Used previously
Partner 3:	First Name: M.I. Last Name:
Title:	% owned:
Drivers License #
SSN#:
Residential Addresses for Past 5 Years	Address: City: State: Zip:
Business Addresses for Past 5 Years	Address: City: State: Zip:
Fictitious Business Name(s) Used previously
Partner 4:	First Name: M.I. Last Name:
Title:	% owned:
Drivers License #
SSN#:
Residential Addresses for Past 5 Years	Address: City: State: Zip:
Business Addresses for Past 5 Years	Address: City: State: Zip:
Fictitious Business Name(s) Used previously
Partner 5:	First Name: M.I. Last Name:
Title:	% owned:
Drivers License #
SSN#:
Residential Addresses for Past 5 Years	Address: City: State: Zip:
Business Addresses for Past 5 Years	Address: City: State: Zip:
Fictitious Business Name(s) Used previously

Individual Accounts
First Name:
M.I.
Last Name:
Age:
Social Security #:
Driver License #:
Street Address:
City:
State:	-Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming    Zip:
Home Phone Number
Type of Home:	House    Apartment    Mobile Home  Own:   Buying   Rent
Years at Present Address:
Previous Address:
Employer's Name:
Occupation:
Monthly Income:
Spouse's Name:
Spouse's S.S.#:
Spouse's Employer:
Spouse's Monthly Income:
Spouse's Mother's Maiden Name
Driver's License #
Has the Applicant or Spouse Ever Filed for Bankruptcy?
Do you wish for your spouse to be considered for credit individually?

Major Credit References (Give only names of those you buy from on open account.)
1.
Company Name:	Contact Person:
Phone:
Address:	City:
State:	-Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming    Zip:
2.
Company:	Contact Person:
Phone:
Address:	City:
State:	-Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming    Zip:
3.
Company:	Contact Person:
Phone:
Address:	City:
State:	-Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming    Zip:

Current Fuel Supplier
Company Name:	Contact Person:
Phone:
Address:	City:
State:	-Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming    Zip:

Bank Reference The undersigned applicant ("Applicant") has made application to Silvas Oil Company, ("Silvas Oil") and/or Tri-Counties Gas Company ("Tri-Counties Gas") for a commercial, and/or individual credit line, and hereby authorizes: Silvas Oil/Tri-Counties Gas to obtain from any credit reporting agency any credit report relating to the undersign which Silvas Oil/Tri-Counties Gas may deem necessary for evaluating the credit line requested by the undersigned. Any bank or other lender or grantor of creditor to provide Silvas Oil/Tri-Counties Gas a copy of the Applicant's most recent financial statement in its possession and information regarding the character, reputation, financial responsibility, and indebtedness of the Applicant as requested by Silvas Oil/Tri-Counties Gas for the purpose of evaluating the commercial, and or individual credit requested of the Applicant. This Authorization shall continue to be valid during any such time period that credit is extended by Silvas Oil/Tri-Counties Gas in order that Silvas Oil/Tri-Counties Gas may protect its financial interest. The Applicant hereby releases Silvas Oil/Tri-Counties gas, or other lender or grantor of credit from any and all claims or cause of action that may arise or which he/she might have by reason of information furnished Silvas Oil/Tri-Counties Gas by a credit reporting agency or by a bank or other lender or grantor of credit.
Name of Bank:	Person to Contact:
Address:
City:
State:	-Select-AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming    Zip:
Type of Relationship
Checking Account #:
Savings Account #:
Loan Account #:
Bank Phone Number
Credit Terms and Agreement The undersigned agrees to pay for all fuel, lubricant and other products within terms setforth on the invoice. The undersigned further agrees to pay a handling charge of $20.00 for each returned check and all collection and legal fees. ALL ACCOUNTS WHICH ARE NOT PAID IN FULL WITHIN FIVE (5) DAYS OF THE DUE DATE SHALL BE ASSESSED A FINANCE CHARGE OF 1 /12 PER MONTH (18% ANNUAL RATE) ON THE UNPAID BALANCE OF THE ACCOUNT. Any actions brought to enforce or interpret the provisions of this Open an Account, or to seek collection on any monies due and owing from the applicant to Silvas Oil/Tri-Counties Gas Company, may be brought in a court of competent jurisdiction in the county of Fresno, State of California.
Name and Title:
Company
Date
Check Here If you Agree to the Credit Terms and Credit Agreement
Personal Guarantee In consideration for the extension of charge card rights for the purchaser of property or service to the applicant, THE UNDERSIGNED PERSONALLY GUARANTEES THE UNCONDITIONAL PAYMENT OF ANY UNPAID AMOUNT UPON APPLICANT'S ACCOUNT. This is a guarantee of payment and not merely of collection; no collection or civil action need be commenced against the Applicant prior to a demand being made upon the undersigned. This is a continuing guarantee, and the obligations of the undersigned are limited, absolute, and unconditional. This continuing guarantee shall continue in effect until all of the obligation owing on the above c\account to Silvas Oil Company ("Silvas Oil") and Tri-Counties Gas Company ("Tri-Counties Gas") have been paid in full. Guarantor agrees to indemnify and hold Silvas Oil/Tri-Counties Gas harmless from and against all claims, actions, cause of action, demand, obligations, liabilities, losses, costs, and expenses in connection with, on account of, or in any related to or arising from the above-referenced account. This continuing guarantee shall not be affected on impaired by any modifications, supplements, extensions or amendment to any contract or agreement to which the parties thereto may hereafter agree. Guarantor agrees to indemnify and hold Silvas Oil/Tri-Counties Gas on account, or pursue any other remedy in the power of Silvas Oil/Tri-Counties Gas, whatsoever. Guarantor waives and defense arising by reason of disability or any other defense which the account debtor may have, or by reason of the cessation from any cause whatsoever of the liability on the above-reference account. The death of Guarantor shall not terminate this continuing guarantee. This continuing guarantee shall be binding upon the heirs, executors, administrators, trustees, beneficiaries, successors, and assigned of Guarantor and shall insure to the benefits of Silvas Oil/Tri-Counties Gas, its successors and assigns. The validity of this continuing guarantee, its construction, interpretation, and enforcement and the right of the parties hereto shall be determined under, governed by, and constructed in accordance with the laws if the State of California. Any actions under this guarantee may be brought in a court of competent jurisdiction in the County of Fresno, State of California. Check Here If you Agree to the Personal Guarantee
Guarantor:
SSN
Drivers License Number:
Date: