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From Information

We are delighted that you are joining us as a new customer. In order that we may process the necessary documents to establish credit, payment terms and the other elements of your account, please complete this online form. You will need the following information handy to finish:

General business contact information for your company and officers
The contact information from 2 different businesses to serve as credit references
Your banking information to complete an EFT Authorization
A copy of your business financials for the past two years, with balance sheet included. Remember that any field with a red star * is a required response.

When you are ready to begin, Press SEND.

Credit amount requested*

Amount

Are you working with

Will you be purchasing tax-free (offroad) dyed diesel?*

yes

Applicants contact info:

Your Full Name

Your Company

Your work phone

Email Address

Your Title

Owner/Principal office info:

Principal office name

Work phone

Your Title

Is the owner or principal officer willing to provide a personal guarantee to obtain or increase credit?

yes

Company info

Legal Company Name

Trade.DBA Name

Company Mailing Address

Address 1

Address 2

City

State

Zip code

Does your Company have a different physical address?

yes

Company phone

Website URL

Applicants contact info:

Organization Type

Year Established

State of incorporation

Is the owner or principal officer willing to provide a personal guarantee to obtain or increase credit?

yes

Federal Tax ID

Who is the key decision maker when your company purchases fuel-related products from Davidson Oil?

Business reference one

Company name – Reference One

Account #

Address

Address 1

Address 2

City

State

Zip code

Full Name of Contact person or credit manager

Work Phone

Email Address or Fax Number

Fax

Your reference is contacted by email. You must enter the correct email address. Please stop to obtain your reference’s email address if you do not have one.

Business reference two

Company name – Reference two

Account #

Address

Address 1

Address 2

City

State

Zip code

Full Name of Contact person or credit manager

Work Phone

Email Address or Fax Number

Fax

Your reference is contacted by email. You must enter the correct email address. Please stop to obtain your reference’s email address if you do not have one.

Bank Reference

Company name – Bank Reference*

Account # – Bank Reference*

Address Bank Reference*

Address 1

Address 2

City

State

Zip code

Full Name Account manager – Bank Reference*

Work Phone – Bank Reference*

Email Address or Fax Number

Fax

Email – Bank Reference*

Your reference is contacted by email. You must enter the correct email address. Please stop to obtain your reference’s email address if you do not have one.

Account Payable Contact

Accounts Payable Contact Person

Accounts Payable Contact’s Title

Address Bank Reference*

Same as Company Mailing Address

Address 1

Address 2

City

State

Zip code

Accounts Payable Work Phone*

Same as Company Mailing Address

Accounts Payable Email

Accounts Payable FAX

Same as Company Mailing Address

Select a Payment Method*

Electronic Funds Transfer (EFT)

Automated Clearing House (ACH)

Credit Card

Your reference is contacted by email. You must enter the correct email address. Please stop to obtain your reference’s email address if you do not have one.

TERMS AND CONDITIONS

Credit Agreement

I certify that the information collected on the Credit Application and supplemental documents presented are complete and accurate as of the date of this application to the best of my knowledge. In consideration of and in order to assist Davidson Oil Company, Flying Star Transport, Advanced Compliance & Testing, Signs of Change, LLC and/or Willborn Bros Co., hereinafter called “Company Group” to establish a line of credit on the foregoing application, the undersigned promises to pay for all purchases in accordance with your terms of sale. I acknowledge and agree that interest at the rate of 1 %% per month (18% per annum) will be charged on all unpaid balances beginning 30 days after the delivery date. Upon final, non- appealable judgment of default, I agree to pay all costs of collection including reasonable attorney’s fees. I agree that this Credit Agreement and the transactions which take place hereunder shall be governed by the laws of the State of Texas and all bills payable therewith in Potter County, Texas.

Returned Check Policy

1. In the event the Applicant should have an EFT bounce or a check returned, we may require a Cashier’s Check, Money Order, or wire transfer to cover the returned check plus all application fee and penalties.
2. Until we receive the guaranteed funds in our office the account is placed on hold and we will not deliver to the account.
3. In the event of this occurrence, we reserve the right to discontinue services

Authorization for Electronic Credit Reference

I understand that the information and statements in this application are furnished to assist Davidson Oil Company, Flying Star Transport, Advanced Compliance & Testing, Signs of Change, LLC and/or Willborn Bros Co., hereinafter called “Company Group”, in establishing credit for the Applicant. I certify that the above information is complete and accurate as of the date of this application. You are hereby authorized to obtain any information you consider necessary from any source concerning the statements in this application. I also authorize these sources, including the Trade References, to release any financial information you require including, but not limited to, credit, financial, salary, banking, debt, and tax information and materials to Company Group, as required, until further notice.

Click to Agree*

By clicking this box, I have read and agree to the above Terms & Conditions

Online Signature for the Terms and Conditions*

Use your mouse to draw your signature above

Wrap-up

Many thanks for all your efforts in completing this information. Once you click SEND, this information will be used to initiate the following next steps.

A copy of this credit application will be emailed to you for your records.
An email will be sent to your trade references automatically.
If you indicated that individuals other than yourself will provide information, they will be emailed automatically.
We will notify you as we make progress toward establishing your company’s line of credit.

Our goal is to process these documents as quickly and with as little paper as possible. We sincerely appreciate all you assistance with this important step in establishing our business relationship.

Form

From Information

Credit amount requested*

Applicants contact info:

Owner/Principal office info:

Company info

Applicants contact info:

Business reference one

Business reference two

Bank Reference

Account Payable Contact

TERMS AND CONDITIONS

Credit Agreement

Returned Check Policy

Authorization for Electronic Credit Reference

Click to Agree*

Online Signature for the Terms and Conditions*

Wrap-up