Credit Application

Please fill out the online credit applecation below or click on the link below to download a printable version of our Credit Application. Please fill it out and fax to (661) 589-2883.

Printable Commercial Credit Application (PDF File, 20k)
The above link requires Adobe Acrobat Reader to view. You can download it for free by clicking on the button to the right.

Online Commercial Credit Application

Sales Rep:

Company Name

Choose One:

Partnership
Proprietorship
Incorporated in the State of

DBA Name
Federal ID#
State Resale #
Corporation ID#

Type Of Business
Phone
Fax
E-Mail

Billing Address

Address
City State Zip

Delivery Address
If the same as billing address check here

Address
City State Zip

Bank Account Information

Bank Acct#
Phone Contact

Bank Acct#
Phone Contact

Bank Acct#
Phone Contact

Trade References

Name
City State
Phone Contact

Name
City State
Phone Contact

Name
City State
Phone Contact

Principals of Company

Name
SS # Title
Home Address:
City State Zip
Home Phone

Name
SS # Title
Home Address:
City State Zip
Home Phone

I agree to pay all invoices on time; pay 1.5% per month service charge on past due amounts, and pays legal costs and attorney fees if collection of account is necessary. I certify the foregoing information is true and correct. I authorize Pence Petroleum Company, Inc. to contact any or all of the above listed banks and trade references for credit verification purposes.
Name
Title Date

Personal Guarantee

In consideration for the extension of credit by Pence Petroleum Company, Inc. to

The undersigned hereby agrees to personally guarantee payment after any indebt ness owing to Pence Petroleum Company, Inc. should legal action be required to collect said indebt ness and to enforce this personal guarantee then the undersigned further agrees to pay reasonable attorney fees and collection costs.
Guarantor Date
Guarantor Date