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Apply For Personal Credit
Download Blank Application
Applicant Info
*Applicant's Legal Name
*SSN
*Date of Birth
*Employer
*Email Address
*Phone Number
Alternate Phone Number
*Desired Credit Limit
Spouse's Info
Spouse's Legal Name
Spouse's Phone Number
Spouse's SSN
Spouse's Date of Birth
Spouse's Employer
Physical Address
*Address
*City
*State
*Zip Code
*Years at Address
Billing Address
Address
City
State
Zip Code
Options/Miscellaneous
Applying For (Check All That Apply)
Electronic Invoices
Electronic Statements
I Prefer
Have you or your spouse ever filed for bankruptcy?
Have you or your spouse ever had a judgment entered against you?
Do you own your residence?
Please provide current landlord's name and contact information (if applicable)
Electronic Payments
Would you like to participate in electronic payments?
Bank Name
Bank Phone Number
Account Number
Confirm Account Number
Routing Number
Confirm Routing Number
Electronic Funds Transfer (EFT) Authorization Agreement
We hereby authorize Whitley Fuel LLC and each of its successors and assigns and other affiliated companies to initiate debit entries to our checking account indicated above and the depository named above (hereinafter called “Depository”) to debit the same to such account. I (we) acknowledge that the origination of ACH transactions to my (our) account must comply with the provisions of U.S. law. This is a binding agreement that may be executed by facsimile. This EFT agreement is to remain in full force and effect until Whitley Fuel LLC and the Depository have received written notification from us in such time and manner as to afford Whitley Fuel LLC and the Depository a reasonable opportunity to act on the notification. This agreement allows Whitley Fuel to charge debits to this account at frequent intervals for varying amounts.
Legal Agreements
Card Lock Agreement
When you receive your card(s), DO NOT write your security number on the card. Your signature verifies that you accept full responsibility for these cards. If any of these cards are lost, stolen, etc., you shall notify Whitley Fuel, LLC, immediately, because it takes a minimum of 24 hours before the cards can be made inactive. In addition, acceptance of these cards indicates full compliance with all fueling and safety procedures and rules as posted at each site.
Terms and Conditions
The applicant hereby applies for credit from Whitley Fuel LLC its Subsidiaries and assigns, existing and that may come to exist (Creditor), and agrees to be bound by all of the terms and conditions contained in this credit application. The applicant agrees to pay for purchases of goods and/or services by the 15th of each month or the invoice due date, whichever is earlier. Creditor reserves the right to terminate credit and/or delivery accommodations at its sole discretion. It is understood the Creditor may impose a delinquency charge, which is the lower of 1% per month or the highest rate allowed by law on any amount that becomes delinquent. The Applicant agrees to be responsible for all collection costs and attorney’s fees incurred in connection with the collection of any delinquent amount, with or without suit, and/ or assigned to a collection agent. Creditor is authorized to check bank and credit references, and to obtain such commercial and/or consumer credit reports Creditor deems necessary to determine credit worthiness of applicant. In the event of litigation, applicant agrees to jurisdiction of the courts of, and venue shall be in, the State of Washington, and County of Okanogan. The person(s) signing this application certify that all of the information contained in this application and any attachment or amendment is true, correct, and complete to the best of their information, knowledge, and belief.