New Customer

Email

Account Name
Phone

Billing Address
Billing City

Billing State
Billing Zip

Emergency Contact Name
Phone

Delivery Address
Delivery City

Delivery State
Delivery Zip

House/Roof Colors
Own Rent

Landlord or Caretaker
Phone

Specific Directions For Delivery/Service

Important Tank Notice

Hyde Fuel requires a full safety inspection of all fuel tanks and supply lines. Any tanks or equipment out of code will require the appropriate measures to fix the code issue before fuel products can be delivered. Please provide the best phone number or email (required fillable field for this info) to schedule this inspection. If your inspection has not be scheduled within 2 business day of completing this form, please contact our office at 518-891-3151.

I agree to appropriate measures to fix the code issue before fuel products can be delivered.
Product
Fuel
Kero
Propane
Gasoline
Diesel

Tank Size
Tank Location

Current Tank Level. Please choose:

Appliances
Leave Invoice
Yes No

Automatic Delivery
Yes No **
**Hyde Fuel would not be responsible for run-outs or possible resulting freeze-ups

**New Propane Customers require a gas check by a Hyde Fuel representative.

For Propane Customers
Is your tank company owned or customer owned?
 Company Owned
 Customer Owned

We value your privacy and personal security. The numbers in this section are encrypted and not stored online.

SS# or Driver's License

Co-Applicant's Name
SS# or DL#
Applicant's Employer
Phone

Co-Applicant's Employer
Phone



Applicant Signature - 11/04/2025


Co-Applicant Signature - 11/04/2025

By providing your Social Security Number, you authorize Hyde Fuel to obtain your credit report.
If this information is not provided, your account will be placed on a Cash on Delivery basis only.
Credit terms are net 10 days from date of delivery. Any balance over 30 days will result in a finance charge (18% per annum) and suspend auto delivery and Hyde Fuel would not be responsible for run-outs or possible resulting freeze-ups.