Online Fuel Order Form

Fuel Order Form

Completing this form will enable Ullman Oil, Inc. to process your fuel order without having to call your order in. Please fill out all fields as completely as possible and hit the SUBMIT FORM Button at the end of the Application. Do NOT forget to submit the form. You will be contacted by email within 48 hours regarding your order. Thank you for choosing Ullman Oil, Inc as your Home Heating Supplier.

If you are a new Customer, please fill out and Submit the New Customer Application before submitting a Fuel Order. The new Customer Application can be accessed from the Home Heating Oil page.

Please provide the following information:

First name (required)
Last name (required)
Middle initial

Street address
Address (cont.)
City
State
Zip code

Home Phone (required)

Email (required)

Delivery and Payment Information

Quantity Ordered:
Fill Tank 150 Gals (minimum order amount) Other Amount

Present Fuel Level:
Empty 1/4 1/2 3/4

Delivery Date Requested:
Emergency* Next day Other

Payment Type:
COD Ullman Oil Account Major Credit Card
HEAP Voucher OTHER

*If this is an emergency fuel order please call 440-543-5195.

Authorization:

I understand that I may submit my fuel order to Ullman Oil, Inc. electronically by clicking "Submit Form". If I choose to submit this order electronically, I acknowledge that, regardless of whether I use a web browser with security features, Ullman Oil, Inc. is unable to ensure that the data will not be intercepted by third parties. I agree that Ullman Oil, Inc. is released from any claims and/or liability in the event that the data in this order is intercepted by third parties.

Copyright 1999-2006 Ullman Oil, Inc. Last revised: December 11, 2006

Copyright 1999-2006 Ullman Oil, Inc.
Last revised: December 11, 2006