Please fill out this form, and sign. Please note that you will not be officially signed up as an automatic customer until this form has been received and processed by our office.

An additional 25 cents is added to the COD price for automatic customers, however, it is fully discounted if the payment is received within 5 days.

A valid credit card is required to have on file. When a credit card is successfully processed for payment, the discount is automatically given.

All subsequent deliveries will be held until balances are paid in full and may not be given the additional discount if the payment is not received in the allotted time period.

Please notify us if there are any major changes in oil usage at any time.

We appreciate your business and look forward to serving you in the future. Please call if you have any questions regarding automatic delivery service or payment policies.

Automatic Delivery Sign up

  • Front, Back, Right side, left side, etc.?
  • If you have a touch screen, please sign. If not, then just enter your initials in the following box.
  • Your initials here.