Regular Order - The Caring Fuel Collective

Customer Details

Full Name / Company Name(Required)

Trading Name (if different)

Company Registration Number (if applicable)

VAT Number (if applicable)

Primary Contact Name

Contact Telephone Number

Email Address for Invoices

Delivery Address (Kerosene Supply Address)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Special Delivery Instructions (Gate codes, tank location, access notes)

Billing Address

Billing Address (If Different from Delivery Address)

Same as Delivery Address

If different, please complete below:

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Tank Information

Tank Size (litres)

Estimated Current Levels (%)

Access Restrictions (if any)

Delivery & Invoicing Preferences

Delivery Type

Automatic Top-Up with a Scheduled Delivery

How Often Would You Like Your Delivery?

Every 1 Month

Every 2 Months

Every 3 Months

Every 4 Months

Every 5 Months

Every 6 Months

Purchase Order Required?

Yes

No

If yes, please explain process:

Accounts Contact (If Different)

Accounts Contact Name

Accounts Email

Accounts Telephone

Data Protection Notice

Caring Fuel Collective will use your information solely for the purpose of arranging and invoicing kerosene deliveries in accordance with UK data protection legislation.

Name

Position (if applicable)

Signature

Date

Authorisation

I confirm that the information provided above is accurate and that I am authorised to request regular kerosene deliveries and invoicing on behalf of the named individual/company.

Regular Kerosene Deliveries