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Palmer Gas and Ermer Oil

Serving your New Hampshire Community since 1932

Serving your Propane and Oil needs for generations...

...with Integrity, Trust, and Value

New Account Application

Please fill in all the information below.
* Required Items

* Name:
* Social Security #:
2nd Name:
* Delivery Address:
* Do you own/rent?:
* Fuel Type:
* Mailing Address:
* Home Phone:
* Daytime Phone:
* Email Address:
Previous address:
Special Delivery Instructions:

I certify that this information is true and complete. I herby authorize Palmer Gas Company, Inc. and /or Ermer Oil Company to investigate my credit background. We will never share personal information with anyone. Information you submit to us is only available to employees of Palmer Gas – Ermer Oil managing your account for the purpose of becoming a new customer for deliveries and service work.

By checking this box, I authorize this firm to enter my property for the purpose of delivering fuel, performing service work, updating or removing equipment. I give permission for Palmer Gas – Ermer Oil Company vehicles to use my driveway for the purpose of making deliveries and/or service work. I understand the Palmer Gas – Ermer Oil is NOT responsible for any damage to my driveway.