Firm Name:
Mailing Address:
City, State, Zip:
Street Address:
City, State, Zip:
Phone Number:
Type of Business:
Date Began:
Organization Type:Corporation Partnership Individual
Federal EIN#:
Social Security #:
Accts Payable:
Credit Amt. Needed:
Sales Tax Exempt:Yes No  (Certificate Required)
Excise Tax Exempt:Yes No  (Certificate Required)
All taxes will be charged unless we have a current exemption certificate on file.
Bank Name:Acct #:
  1. Our standard terms are net 30 days from date of purchase.
    Charges from service stations are due upon receipt of monthly statement.
  2. A finance charge of 1.50% (APR 18%) will be added to invoices more than 30 days old.
  3. In the event any BALANCE of any INVOICE that is NOT PAID within 30 days of the date of the invoice, your right to purchase on credit may be terminated or limited at the discretion of Hill City Oil Co., Inc.
  4. Applicant agrees that if any payment is not made when due, and collection of any amount is placed in the hands of an attorney for collection, or suit is filed thereon, or proceedings are had in the probate, bankruptcy, receivership, arrangement or other legal proceedings for collection of any such amount, Applicant agrees to pay costs and expenses of collection, including reasonable attorney's fees.
By pressing submit, you agree to all terms specified on this page and that you have the authority to enter into this agreement.