Automatic Delivery Application Fields marked with an * are required Please enable JavaScript in your browser to complete this form.Name *Full Address *Phone Number *Email Address *1. how many gallons of heating oil did you use last year? *2. How much oil is in your tank now? Gauge reading:3. Is oil your primary source of heat? *YesNo4. Do you have an alternate source of heat? *YesNo5. Do you use heating oil for hot water? *YesNoOnly in Winter6. What color is your house? *7. Do we have permission to use your driveway? *YesNo8. What size is your tank? *9. Is access to the fill pipe restricted in bad weather? (ice and snow) *YesNoMultiple Choice *FrontBackLeftRightFront - LeftBack - LeftFront - RightBack - RightGarageOtherI authorize FJB Oil Company to run a pre-authorization on my credit card prior to the delivery and process the full payment once the delivery is made. *Anything else we should know? *WebsiteSubmit Now
