Online Account Application - Davis Oil Keene NH

If you are an existing Davis Oil customer, you can reset your access here. To become a new Davis Oil customer, you could complete the account application below or stop by our office.

Name*
First Last
Email*
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Birth Date*
Date Format: MM slash DD slash YYYY
Social Security #
Employer*
Employer Address*
Street Address Address Line 2 City State ZIP Code
Position*
How Long*
Spouse's Name
First Last
Spouse's Birth Date
Date Format: MM slash DD slash YYYY
Spouse's Social Security #
Spouse's Employer
Spouse's Employer Address
Street Address Address Line 2 City State ZIP Code
Position
How Long
Previous Oil Dealer
Address
Street Address Address Line 2 City State ZIP Code
Residence*
If Renting, Landlord's Name*
Landlord's Phone*
Previous Years Oil Consumption (if known)
As Of Date*
Date Format: MM slash DD slash YYYY
Your Tank Is*
- 1/4
- 1/2
- 3/4
- Full
Is Hot Water Off Furnace*
- Yes
- No
Do you want automatic delivery*
- Yes
- No
Where Would You Like The Delivery Ticket Left*
Where is the fill pipe located?*
Please describe where your fill pipe is located. (example: driveway side fill or around back by deck)
Would you like Paperless statements?*
- Yes, please email statements.
House Description*
Please describe your house and/or the area around your house . (example: white house with black shutters, long driveway with a red mailbox)
Do You Use An Alternate Source Of Heat*
Signature*
By entering your name here and submitting this form you promise that everything you have stated in this application is correct to the best of your knowledge.
Date*
Date Format: MM slash DD slash YYYY
Comments
This field is for validation purposes and should be left unchanged.

Judie Tobin

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