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<form action="/index.php" method="post" class="wpcf7-form">
  <div class="customer-form"><label><strong>First Name<span class="req">*</span></strong><span class="wpcf7-form-control-wrap first-name"><input type="text" name="first-name" value="" size="40"
          class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true" required="required" aria-invalid="false"></span> </label><br>
    <label><strong>Last Name<span class="req">*</span></strong><span class="wpcf7-form-control-wrap last-name"><input type="text" name="last-name" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required"
          aria-required="true" required="required" aria-invalid="false"></span> </label><br>
    <label><strong>Date of Birth<span class="req">*</span></strong><span class="wpcf7-form-control-wrap dob"><input type="text" name="dobM" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true"
          style="width:100px;" placeholder="Month" required="required" aria-invalid="false" maxlength="2"></span>
      <span class="wpcf7-form-control-wrap dob"><input type="text" name="dobD" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true" maxlength="2" required="required" aria-invalid="false"
          style="width:100px;" placeholder="Day"></span>
      <span class="wpcf7-form-control-wrap dob"><input type="text" name="dobY" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true" placeholder="Year" maxlength="4" min-length="4"
          required="required" aria-invalid="false" style="width:100px;"></span></label><br>
    <label><strong>Address<span class="req">*</span></strong><span class="wpcf7-form-control-wrap address1"><input type="text" name="address1" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true"
          required="required" aria-invalid="false"></span> </label><br>
    <label><strong>City<span class="req">*</span></strong><span class="wpcf7-form-control-wrap city"><input type="text" name="city" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true"
          required="required" aria-invalid="false"></span> </label><br>
    <label><strong>State<span class="req">*</span></strong><span class="wpcf7-form-control-wrap state"><select name="state" class="wpcf7-form-control wpcf7-select" aria-invalid="false">
          <option value="Alabama">Alabama</option>
          <option value="Alaska">Alaska</option>
          <option value="Arizona">Arizona</option>
          <option value="Arkansas">Arkansas</option>
          <option value="California">California</option>
          <option value="Colorado">Colorado</option>
          <option value="Connecticut">Connecticut</option>
          <option value="Delaware">Delaware</option>
          <option value="Florida">Florida</option>
          <option value="Georgia">Georgia</option>
          <option value="Hawaii">Hawaii</option>
          <option value="Idaho">Idaho</option>
          <option value="Illinois">Illinois</option>
          <option value="Indiana">Indiana</option>
          <option value="Iowa">Iowa</option>
          <option value="Kansas">Kansas</option>
          <option value="Kentucky">Kentucky</option>
          <option value="Louisiana">Louisiana</option>
          <option value="Maine">Maine</option>
          <option value="Maryland">Maryland</option>
          <option value="Massachusetts">Massachusetts</option>
          <option value="Michigan">Michigan</option>
          <option value="Minnesota">Minnesota</option>
          <option value="Mississippi">Mississippi</option>
          <option value="Missouri">Missouri</option>
          <option value="Montana">Montana</option>
          <option value="Nebraska">Nebraska</option>
          <option value="Nevada">Nevada</option>
          <option value="New Hampshire">New Hampshire</option>
          <option value="New Jersey">New Jersey</option>
          <option value="New Mexico">New Mexico</option>
          <option value="New York">New York</option>
          <option value="North Carolina">North Carolina</option>
          <option value="North Dakota">North Dakota</option>
          <option value="Ohio">Ohio</option>
          <option value="Oklahoma">Oklahoma</option>
          <option value="Oregon">Oregon</option>
          <option value="Pennsylvania">Pennsylvania</option>
          <option value="Rhode Island">Rhode Island</option>
          <option value="South Carolina">South Carolina</option>
          <option value="South Dakota">South Dakota</option>
          <option value="Tennessee">Tennessee</option>
          <option value="Texas">Texas</option>
          <option value="Utah">Utah</option>
          <option value="Vermont">Vermont</option>
          <option value="Virginia">Virginia</option>
          <option value="Washington">Washington</option>
          <option value="West Virginia">West Virginia</option>
          <option value="Wisconsin">Wisconsin</option>
          <option value="Wyoming">Wyoming</option>
          <option value="District of Columbia">District of Columbia</option>
        </select></span> </label><br>
    <label><strong>Zip Code<span class="req">*</span></strong><span class="wpcf7-form-control-wrap zip"><input type="text" name="zip" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true"
          required="required" aria-invalid="false"></span> </label><br>
    <label><strong>Home Phone<span class="req">*</span></strong><span class="wpcf7-form-control-wrap home-phone"><input type="text" name="home-phone" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required"
          aria-required="true" required="required" aria-invalid="false"></span> </label><br>
    <label><strong>Cell Phone</strong><span class="wpcf7-form-control-wrap cell-phone"><input type="text" name="cell-phone" value="" size="40" class="wpcf7-form-control wpcf7-text" aria-invalid="false"></span> </label><br>
    <label><strong>Email<span class="req">*</span></strong><span class="wpcf7-form-control-wrap email-address"><input type="email" name="email-address" value="" size="40"
          class="wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-required wpcf7-validates-as-email" aria-required="true" required="required" aria-invalid="false"></span> </label><br>
    <label><strong>How long at this address?</strong><span class="wpcf7-form-control-wrap address-howlong"><input type="text" name="address-howlong" value="" size="40" class="wpcf7-form-control wpcf7-text" aria-invalid="false"></span> </label><br>
    <label><strong>Former Address</strong><span class="wpcf7-form-control-wrap address-former"><input type="text" name="address-former" value="" size="40" class="wpcf7-form-control wpcf7-text" aria-invalid="false"></span> </label><br>
    <label><strong>Social Security Number<span class="req">*</span></strong><span class="wpcf7-form-control-wrap ssn"><input type="text" name="ssn" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required"
          aria-required="true" required="required" aria-invalid="false"></span> </label><br>
    <label><strong>Employer</strong><span class="wpcf7-form-control-wrap employer"><input type="text" name="employer" value="" size="40" class="wpcf7-form-control wpcf7-text" aria-invalid="false"></span> </label><br>
    <label><strong>Work Phone</strong><span class="wpcf7-form-control-wrap work-phone"><input type="text" name="work-phone" value="" size="40" class="wpcf7-form-control wpcf7-text" aria-invalid="false"></span> </label><br>
    <label><strong>Fuel Options<span class="req">*</span></strong><span class="wpcf7-form-control-wrap fueloptions"><span class="wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox"><span
            class="wpcf7-list-item first"><label><input type="radio" name="fueloptions" value="Oil"><span class="wpcf7-list-item-label">Oil</span></label>
          </span><span class="wpcf7-list-item last"><label><input type="radio" name="fueloptions" value="Propane"><span class="wpcf7-list-item-label">Propane</span>
            </label>
          </span>
        </span>
      </span>
    </label><br>
    <label><strong>Fuel Inventory<span class="req">*</span></strong><span class="wpcf7-form-control-wrap menu-88"><select name="fuel-needed" class="wpcf7-form-control wpcf7-select wpcf7-validates-as-required" aria-required="true" required="required"
          aria-invalid="false">
          <option value="Choose From An Option Below">Choose From An Option Below</option>
          <option value="Heating Oil: Empty">Heating Oil: Empty</option>
          <option value="Heating Oil: 1/8">Heating Oil: 1/8</option>
          <option value="Heating Oil: 1/4">Heating Oil: 1/4</option>
          <option value="Heating Oil: 1/2">Heating Oil: 1/2</option>
          <option value="Heating Oil: 3/4">Heating Oil: 3/4</option>
          <option value="Heating Oil: Full">Heating Oil: Full</option>
          <option value="Heating Oil: Unsure">Heating Oil: Unsure</option>
          <option value="Propane: Less than 10%">Propane: Less than 10%</option>
          <option value="Propane: 10-20%">Propane: 10-20%</option>
          <option value="Propane: 20-30%">Propane: 20-30%</option>
          <option value="Propane: 30-40%">Propane: 30-40%</option>
          <option value="Propane: 40-50%">Propane: 40-50%</option>
          <option value="Propane: 50-60%">Propane: 50-60%</option>
          <option value="Propane: 60-70%">Propane: 60-70%</option>
          <option value="Propane: 70-80%">Propane: 70-80%</option>
          <option value="Propane: Unsure">Propane: Unsure</option>
        </select></span></label><br>
    <label><strong>Delivery Method<span class="req">*</span></strong><span class="wpcf7-form-control-wrap deliverymethod"><span class="wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox"><span
            class="wpcf7-list-item first"><label><input type="radio" name="deliverymethod" value="Automatic"><span class="wpcf7-list-item-label">Automatic</span></label>
          </span><span class="wpcf7-list-item last"><label><input type="radio" name="deliverymethod" value="Will Call"><span class="wpcf7-list-item-label">Will Call</span>
            </label>
          </span>
        </span>
      </span>
    </label><br>
    <label><strong>Paperless Billing? Considering the environmental benefits, you will automatically be enrolled in paperless billing. If you prefer to receive paper bills, select 'No' below.<span class="req">*</span> </strong><span
        class="wpcf7-form-control-wrap email-billing"><span class="wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required wpcf7-exclusive-checkbox"><span class="wpcf7-list-item first"><label><input type="radio" name="email-billing" value="Yes"
                checked="checked"><span class="wpcf7-list-item-label">Yes</span></label>
          </span><span class="wpcf7-list-item last"><label><input type="radio" name="email-billing" value="No"><span class="wpcf7-list-item-label">No</span>
            </label>
          </span>
        </span>
      </span>
    </label><br>
    <label><strong>Billing Email<span class="req">*</span></strong><span class="wpcf7-form-control-wrap billing"><input type="email" name="billing" value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-email"
          aria-invalid="false"></span> </label><br>
    <label><strong>Are you interested in our payment plan?</strong> <span class="wpcf7-form-control-wrap payment-plan"><span class="wpcf7-form-control wpcf7-checkbox wpcf7-exclusive-checkbox"><span class="wpcf7-list-item first"><label><input
                type="radio" name="payment-plan" value="Yes"><span class="wpcf7-list-item-label">Yes</span></label>
          </span><span class="wpcf7-list-item last"><label><input type="radio" name="payment-plan" value="No"><span class="wpcf7-list-item-label">No</span>
            </label>
          </span>
        </span>
      </span>
    </label><br>
    <label><strong>Do you own or rent your home?</strong><span class="wpcf7-form-control-wrap mortgage-landlord"><span class="wpcf7-form-control wpcf7-checkbox wpcf7-exclusive-checkbox"><span class="wpcf7-list-item first"><label><input type="radio"
                name="mortgage-landlord" value="Own"><span class="wpcf7-list-item-label">Own</span></label>
          </span><span class="wpcf7-list-item last"><label><input type="radio" name="mortgage-landlord" value="Rent"><span class="wpcf7-list-item-label">Rent</span>
            </label>
          </span>
        </span>
      </span>
    </label><br>
    <label><strong>If you own, who is your mortgage company? Or if you rent, what is your landlord's name and address?</strong><span class="wpcf7-form-control-wrap mortgage-landlord"><input type="text" name="mortgage-landlord" value="" size="40"
          class="wpcf7-form-control wpcf7-text " aria-invalid="false"></span> </label><br>
    <label> How did you hear about us? <span class="req">*</span><span class="wpcf7-form-control-wrap hearaboutus"><select name="hearaboutus" aria-required="true" required="required" class="wpcf7-form-control wpcf7-select wpcf7-validates-as-required"
          aria-invalid="false">
          <option value="">Please Select</option>
          <option value="Friend">Friend</option>
          <option value="Social Media">Social Media</option>
          <option value="Neighbor">Neighbor</option>
          <option value="Internet Search">Internet Search</option>
          <option value="Saw Trucks">Saw Trucks</option>
          <option value="Mailing">Mailing</option>
          <option value="Other">Other</option>
        </select></span></label>
    <p></p>
    <div class="terms-box">I authorize Devaney Energy Inc. to check my credit record and to report to Credit Bureaus and lawful recipients my performance of the account applied for. If credit is extended as a result of this application, I agree to
      pay in full within 10 days after billing date without finance charge. Budget accounts available upon request on which no finance charge is assessed if payments are made as agreed.<p></p>
      <p>In case of errors or inquiries about your bill send your inquiry in writing to Devaney Energy Inc. 177 Wells Avenue, P.O. Box 9120, Newton, MA 02459 (on a separate sheet) so that we may receive it within 60 days after the bill was mailed to
        you. Your written inquiry must include:</p>
      <p>Your name and account number (if any)<br> A description of the error and why (to what extent you can explain) you believe it is an error; and<br> The dollar amount of the suspected error.<br>You remain obligated to pay the parts of your bill
        not in dispute, but you do not have to pay any amount in dispute during the time the Creditor is resolving the dispute. During the same time, the Creditor may not take action to collect disputed amounts or report disputed amounts as
        delinquent.</p>
      <p>In compliance with Massachusetts General Law Chapter 93C your letter will be acknowledged within 14 days of receipt and handling concluded within 60 days or a maximum of 120 days if further correspondence about the matter is necessary.</p>
      <p>Finance Charges<br> Regular Accounts - There will be a finance charge computed by a periodic rate of 1-1/2% per month for a balance existing after thirty (30) days from the closing date, which is an annual percentage rate of 18%. Finance
        charges may be avoided by paying the "new balance" before the billing date of the next month.</p>
      <p>Budget Accounts - No finance charge when payments are made in accordance with budget credit terms.</p>
      <p>Automatic fuel oil deliveries may be discontinued if account is not kept current.</p>
      <p>The customer will be required to pay the company's costs of collection, including reasonable attorney's fees, if this account is not paid when due.</p>
      <p>Cancellation of your account at any time for any reason must be done in writing and sent to P.O Box 9120, Newton, MA 02459-9120. </p>
    </div>
    <p><label class="agree"><span class="wpcf7-form-control-wrap term-agree"><span class="wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required"><span class="wpcf7-list-item first last"><input type="checkbox" name="term-agree[]"
                value="I agree to the terms and conditions."><span class="wpcf7-list-item-label">I agree to the terms and conditions.</span></span></span></span></label><br>
      <label class="dig-sig"><strong>Digital Signature<span style="color:red;"><span class="req">*</span></span></strong><span class="wpcf7-form-control-wrap digital-signature"><input type="text" name="digital-signature" value="" size="40"
            class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true" required="required" aria-invalid="false"></span> </label><br>
      <label class="todays-date"><strong>Today's Date<span style="color:red;"><span class="req">*</span></span> Please enter date in mm/dd/year format.</strong><span class="wpcf7-form-control-wrap todays-date"><input type="text" name="todays-date"
            value="" size="40" class="wpcf7-form-control wpcf7-text wpcf7-validates-as-required" aria-required="true" required="required" aria-invalid="false"></span></label>
    </p>
    <p><input type="submit" id="appsub" value="Submit to Devaney Energy" class="wpcf7-form-control ">
    </p>
  </div>
  <div class="wpcf7-response-output wpcf7-display-none"></div>
</form>

Text Content

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Home > Customer Application


RESIDENTIAL APPLICATION


RESIDENTIAL CHARGE ACCOUNT APPLICATION

Please complete the secure form below and submit it to our Customer Service
department for review. One of our representatives will be in touch with your
shortly to finalize the application.

First Name*
Last Name*
Date of Birth*
Address*
City*
State* Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware
Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana
Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana
Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina
North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South
Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin
Wyoming District of Columbia
Zip Code*
Home Phone*
Cell Phone
Email*
How long at this address?
Former Address
Social Security Number*
Employer
Work Phone
Fuel Options*Oil Propane
Fuel Inventory* Choose From An Option Below Heating Oil: Empty Heating Oil: 1/8
Heating Oil: 1/4 Heating Oil: 1/2 Heating Oil: 3/4 Heating Oil: Full Heating
Oil: Unsure Propane: Less than 10% Propane: 10-20% Propane: 20-30% Propane:
30-40% Propane: 40-50% Propane: 50-60% Propane: 60-70% Propane: 70-80% Propane:
Unsure
Delivery Method*Automatic Will Call
Paperless Billing? Considering the environmental benefits, you will
automatically be enrolled in paperless billing. If you prefer to receive paper
bills, select 'No' below.* Yes No
Billing Email*
Are you interested in our payment plan? Yes No
Do you own or rent your home?Own Rent
If you own, who is your mortgage company? Or if you rent, what is your
landlord's name and address?
How did you hear about us? * Please Select Friend Social Media Neighbor Internet
Search Saw Trucks Mailing Other



I authorize Devaney Energy Inc. to check my credit record and to report to
Credit Bureaus and lawful recipients my performance of the account applied for.
If credit is extended as a result of this application, I agree to pay in full
within 10 days after billing date without finance charge. Budget accounts
available upon request on which no finance charge is assessed if payments are
made as agreed.



In case of errors or inquiries about your bill send your inquiry in writing to
Devaney Energy Inc. 177 Wells Avenue, P.O. Box 9120, Newton, MA 02459 (on a
separate sheet) so that we may receive it within 60 days after the bill was
mailed to you. Your written inquiry must include:

Your name and account number (if any)
A description of the error and why (to what extent you can explain) you believe
it is an error; and
The dollar amount of the suspected error.
You remain obligated to pay the parts of your bill not in dispute, but you do
not have to pay any amount in dispute during the time the Creditor is resolving
the dispute. During the same time, the Creditor may not take action to collect
disputed amounts or report disputed amounts as delinquent.

In compliance with Massachusetts General Law Chapter 93C your letter will be
acknowledged within 14 days of receipt and handling concluded within 60 days or
a maximum of 120 days if further correspondence about the matter is necessary.

Finance Charges
Regular Accounts - There will be a finance charge computed by a periodic rate of
1-1/2% per month for a balance existing after thirty (30) days from the closing
date, which is an annual percentage rate of 18%. Finance charges may be avoided
by paying the "new balance" before the billing date of the next month.

Budget Accounts - No finance charge when payments are made in accordance with
budget credit terms.

Automatic fuel oil deliveries may be discontinued if account is not kept
current.

The customer will be required to pay the company's costs of collection,
including reasonable attorney's fees, if this account is not paid when due.

Cancellation of your account at any time for any reason must be done in writing
and sent to P.O Box 9120, Newton, MA 02459-9120.

I agree to the terms and conditions.
Digital Signature*
Today's Date* Please enter date in mm/dd/year format.







DEVANEY ENERGY

Since 1934, Devaney Energy has been the trusted leader in delivering residential
and commercial energy solutions. Family-owned and operated, now in our fourth
generation, we take pride in being leaders in our industry and the local
communities we work in and serve.

©2019 Devaney Energy, Inc. All rights reserved.


FOR YOUR HOME

 * Heating Oil
 * Propane
 * Natural Gas & Electricity
 * Maintenance & Repair
 * Heating Equipment
 * Cooling Equipment


FOR YOUR BUSINESS

 * Contact Us
 * Natural Gas & Electricity


LET’S TALK

Call us: 866-964-8383

info@devaneyenergy.com

177 Wells Avenue, P.O. Box 9120,
Newton, MA 02459-9120

 * Contact Us
 * Natural Gas & Electricity

(866) 964-8383