REO and Sons Fuel
Last Name:
First Name:
Address:
City:
Zip Code:
Home Phone:
Cell Phone:
Email:
275 gal
Tank Size:
 Larger
 Unknown
Smaller
Tank Location:
 Inside
Outside
 Unknown
Rear
R
i
g
h
t
L
e
f
t
Fill Pipe Location:
(Looking at House)
Front
Description of Home:
(i.e Tan Rancher)
Payment Method:
Cash
 Check
No
Would you like a free tank inspection?
 Yes
Are you home during the day?
No
Yes
Are you interested in Auto-Fill?
No
Yes
Unsure
How did you hear about us?
Internet
Penny Power
U P Shoppers Guide
Family/Friend
Other (Please Specify)
Special Instructions:
(i.e anything out of the ordinary about
your fill that we should know)
If you are a new customer or even a returning customer that has not officially
registered with us, we would appreciate it if you would take the time to fill out
the form below.  This form enables us to keep all of our customers on record
and greatly reduce the time it takes to place future orders, resulting in much
faster delivery time for you, our valued customer.  If you have completed this form
before and wish to place an online order, you do not need to complete this form again, simply click
on the "Order Now" tab located on your left.
Thank You!
Register with us!
Once you have created an account you can place an Online order.