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Have an gas leak or notice the smell of gas? Call Lp Propane or 911.
(208) 529-4976
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Credit Application
Propane Account Type
(Required)
Residential (for Home)
Commercial (for Business)
Company Name
(Required)
Business Type
(Required)
Sole Proprietor
Limited Liability Company
Corporation
Name
(Required)
First
Last
Who is the designated contact person for the business
(Required)
First
Last
Job Title
(Required)
Phone
Email
Service Address
(Required)
Street Address
City
State
ZIP / Postal Code
Is the service address the same as the billing address
(Required)
Yes
No
Billing Address
(Required)
Street Address
City
State
ZIP / Postal Code
Accounts Payable Contact Name
(Required)
Accounts Payable Phone Number
(Required)
Company EIN Number
(Required)
Social Security Number or Driver License Number
Date of Birth
(Required)
Employer Name
(Required)
Employer Phone Number
(Required)
Type of structure being serviced
(Required)
New Building
Existing Building
Structure Type
(Required)
Home
Mobile Home
Commercial Building / Shop
Other
Is the structure owned or leased?
(Required)
Owned
Leased
Employer Name
(Required)
Employer Phone Number
(Required)
What propane appliances does the structure have?
Furnace
Water Heater
Cook Stove
Dryer
Garage Heater
Fireplace
Are purchase orders required?
(Required)
Yes
No
Leave a delivery ticket on site?
(Required)
Yes
No
Signature Required?
(Required)
Yes
No
Would you like continue with paperless statements to save on your bill.
(Required)
Opt for paperless to avoid incurring a $4.95 fee for paper statements.
Yes
No
Choose the best propane program for your needs.
(Required)
Autofill - LP Propane is responsible for filling your tank. Will Call - The owner is responsible to give 3 days lead time to fill their tank, if the tank runs empty or an emergency fill is required additional fees will apply.
Auto Fill (RECOMMENDED)
Wil Call
What is your preferred payment option?
(Required)
A representative from our office will contact you to collect your payment details. Refer to Terms and Conditions outlined below.
Auto Pay (RECOMMENDED)
Level Pay (Level pay is available after one year or record of annual usage.)
Does the customer own their propane tank?
(Required)
Yes
No
Do you need us to fill your tank at this time? ONLY for existing tanks.
Yes
No
What is the current percentage of your propane tank?
(Required)
Customer requires tank install by:
You will be contacted for an official install date, we will do our best to accommodate your request.
MM slash DD slash YYYY
Description of proposed tank location.
Is the location accessible for installing and filling the tank without obstacles of 100 feet or closer?
(Required)
Yes
No
List obstacles that would hinder install or fill.
Name of sales representative
(Required)
No Sales Representative
Casey Bradshaw
Greg Larson
Jared Cooper
Kevin Downs
Refer a friend for $150
Just fill out this form, and we’ll invite your friend to join LP Propane. When your referral has signed up and paid for their first delivery (of 200 Gallons or more) less their $150 referral credit, we’ll apply a $150 credit to your account.
First Name
Last Name
Referral Email
Referral Phone
Category List
(Required)
Agricultural
Aviation
Commercial
Construction
Government
Highway/Transportation
Manufacturing /Production
Metal Working
Mining
Residential
Other
How did you hear about Lp Propane?
(Required)
Referral
Sales Representative
Acquisitions
Billboards
Radio
Direct Mailer
Event / Trade Show
Online Search
Social Media
TV
Other
Signature
(Required)
NEW ACCOUNTS MUST PAY A TANK SET FEE. The fee varies depending on distance and size of gas line and regulators, generally between $500 and $600 (This is an estimate only) Fee includes tank delivery, labor, poly pipe gas line and risers, trenching, regulators, and gas check. Additional materials and labor will be subject to additional costs. If trenching is required, LP PROPANE LLC will call for utility locates. Customer agrees to pay for any charges that may occur for line locates or required permits and agrees to hold LP PROPANE LLC harmless in the event that underground service lines (telephone, electrical, cable tv, sewer, water, etc) are damaged as a result of trenching. Trenching may not be available in all locations. Propane is not included in the fee. Leased Tank Terms: 1. Tank: This lease covers the tank and valves that are part of the tank only and is non-refundable and non-transferable 2. Repair: The lines and regulators connecting the propane tank to the residence or other structure(s) supplied by the tank are the customer’s property and responsibility. In the event that any lines or regulators require service, LP Propane may provide service and repair, and reserves the right to charge the customer reasonable/customary rates for any services provided. 3. Limitations on use: Customer will not permit any propane or other product to be delivered into the lease equipment by anyone other than LP Propane and must not be moved, handled, or maintained by anyone other than LP Propane or someone authorized by LP Propane. 4. Outage: If requesting a delivery after normal business hours or the tank runs empty, an ‘Emergency Delivery Fee’ may be applied. If the tank is empty, a leak inspection will be performed, and a ‘Leak Test Fee’ may be applied. 5. Property Access: LP Propane may enter customer’s premises to install, perform necessary repairs, or to remove the tank. 6. Termination: Upon termination of this lease and pick up of the tank, LP Propane may buy back any propane left in the tank. In the event customer sells the property, and remaining propane in the tank shall be part of the transaction between customer and the new owner. Customer may contact us at any time to obtain the value of the propane. 7. Code: Customer system must comply with all applicable regulations, standards, and codes and must pass a gas check inspection. Combustible materials shall not be stored within 10 feet of the tank. Structures and sources of ignition shall be distanced from the tank as required by the LP gas code. 8. Miscellaneous: This writing constitutes the entire agreement between customer and LP Propane. Any changes to this agreement shall be signed in writing. This tank lease is governed by the laws of Idaho. CREDIT TERMS: Payment terms are set by the credit department and can be changed without prior notice. Charges not paid within the set payment terms of the invoice may be subject to a finance charge of up to 2% per month or 24% per annum. Customers on credit can be changed to a ‘Cash before delivery and Will Call status’ if their balance becomes 60 days past due. Failure to pay charges and/or interest may result in a referral to collections. Customer agrees to pay all applicable fees associated with collections, including but not limited to, Debt recovery fees, Attorney fees, Court costs. Level-Pay and Autopay plans may be available. Customers on Level-Pay are required to make automatic monthly payments initiated by LP Propane and will be reviewed annually to settle any remaining balance on their account as well as any adjustment to payment amount as needed. Level-Pay customers who become two months behind on payments will be taken off the Level-Pay program and required to pay any balance immediately. Customers on Autopay will have their preferred payment method charged within 7 days of delivery. Customers not extended credit will be placed on COD terms and will need to pay for charges in advance.
Signature Date
MM slash DD slash YYYY
Δ
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