Efficient Energy Systems, Inc
Heating your home for less!!
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Customer / Credit Application 


Applicant Information


Customer Name:
Address:
City:
State:
Zip Code:
Home Phone:
Cell Phone:
Work Phone:
SSN:
Work Location:
Email Address:

Equipment Details


Is your oil tank underground ?
What size is your oil tank ?
Current oil level in your tank ?
Tell us about your heating system:
Last date of Annual Maintenance:
Former Oil Company Name:
Send a cancellation letter?
How do you heat your Hot Water?
Location of fill pipe (facing house from street):
Comments:
   
OIL TANK - I have inspected my oil tank (tanks) and have found no signs of leaks,srews or any type of patches. I also have the proper permit from local fire dept. for oil storage on my property.
OIL LINE - I have inspected my oil line running from the oil tank to the oil burner and found it to be encassed in a plastic sleeve (protected) or a oil safety valve installed. I am aware that either must be in place to be in complance with State codes and insurance requirements.
DELIVERY and SERVICE - I authorize EES to drive delivery or service vehicles on my property for filling my oil tank or perform service on my heating equipement.