Rich Square, NC
Wake Forest, NC
Mount Joy, PA
TELL US ABOUT YOURSELF
Date of Birth
# in Household
Address Line 2
Driver's License #
Social Security #
Landlord or Mortgage Holder
About Your Home
ABOUT YOUR HEATING NEEDS
# of Rooms to Heat
Type of Heat
Do you have a propane fired H/W Heater?
Type of product you use
Size of Storage Tank
Type of Storage Tank
Payment Plan Desired
Budget Plan account
Type of Service Desired
Previous Propane Supplier
The terms "I", "me" and "my" mean each person or legal entity signing below.
I am providing this application and information for the purpose of obtaining or maintaining credit with Diversified Energy, LLC ("D.E.") on behalf of myself/ourselves or on behalf of others whose credit I endorse co-sign or guarantee. I understand that D.E. is relying on the information provided with this statement (including the designations made as to ownership of property) in deciding to grant or continue credit. I certify that the foregoing information has been supplied truthfully, accurately, and voluntarily and therefore authorize D.E. to investigate my credit worthiness, credit history and financial responsibility through any credit bureau or by any other reasonable means, including direct contact with past and present creditors. I authorize banks and other financial institutions to give information to D.E. in connection with this transaction about my savings and checking accounts and loans. I also authorize D.E. to answer questions and inquiries from others seeking credit experience or information about me.
Credit Terms: The due date for payment for all purchases, fees and advances is thirty (30) days after the invoice date, regardless of when I receive such invoice. Late charges are imposed only if payment is not made in full by the due date of payment. If full payment is not made by the due date, a Late Charge will be imposed at the rate of one and one-half percent (1.5%) per month computed on the unpaid portion of the balance of the previous invoice less payments made or credit given during the previous invoice period. A service charge of twenty-five dollars ($25) (or the highest amount permitted by law, whichever is less) will be imposed if any check received by D.E. on my account is dishonored for any reason.
D.E. is authorized to establish a credit limit and to modify the credit limit from time to time by increasing or decreasing the line as D.E. shall determine in its sole discretion. I agree not to exceed my maximum credit limit. I promise to pay to D.E. or its order, and successors and assigns, all amounts advanced hereunder in the form of credit purchases from D.E., together with accrued interest as provided herein and all other costs and expenses provided herein and in any other instrument, invoice or agreement. I understand that D.E. has the right to terminate this Agreement upon ten (10) days written notice to me. Each person singing below is both individually and jointly liable with the other for all obligations incurred hereunder. I agree to execute such instruments and evidences of indebtedness as D.E. shall require in connection herewith.
I understand that I will be in default under this Agreement if any of the following occur:
I fail to comply with the payment requirements or any other terms or conditions of this Agreement or any other agreement I have with D.E.,
If I die or become insolvent;
If any action or proceeding is started under any bankruptcy or insolvency law by or against me;
If a receiver is appointed or a writ or order of attachment, levy or garnishment is issued against me or any of my property, assets or income;
If D.E. considers itself or any debts due hereunder unsafe or not completely secure or if D.E. believes, in good faith, that the chances of my paying or performing all of my obligations under this Agreement or any agreement I have with D.E. have been impaired;
If I fail to stay within my approved credit limit; or
If I fail to provide complete and accurate financial statements and other financial information within 10 days after a request by D.E. or if any financial information I give to D.E. is incorrect or misleading.
If I am in default under this Agreement or if this Agreement is terminated, D.E. may declare all amounts owing hereunder to be immediately due and payable, without notifying me.
This Credit Agreement shall be governed by the laws of the State of North Carolina.
I agree to pay D.E. promptly in accordance with the above credit terms, or other credit terms as offered to me by D.E., but such credit terms other than those outlined above will be offered only at the option of D.E.
In the event D.E. initiates any legal proceedings or incurs any legal expenses or attorneys' fees in exercising any of its rights or remedies upon default, whether or not there is a lawsuit, such expenses and reasonable attorneys' fees shall be added to the principal balance due and I shall be liable for the payment of same as an additional obligation under this Agreement.
I have read and agree to all terms set forth in this Agreement and acknowledge receipt of a copy of the Agreement by my signature below.