Express Oil Change & Tire Engineers Kingsport TN

Express Oil Change & Tire Engineers® in Kingsport TN is a family-owned and operated, full-service oil change, tire store, and automotive repair shop specializing in a wide range of services to address your preventative maintenance and automotive repair needs.

Electronic Credit Application for Fleet Services

Information collected in this electronic form is submitted directly to contact@eoctricities.com, the official email address for Express Oil Change in Kingsport / Tri-Cities TN.  Should you have concerns about submitting your form electronically, you can download a pdf document here to submit to Express Oil Change through fax or postal mail.  


The majority of fields in this form are required for electronic submission, however should you have special needs, questions or requests there is an open text field near the end for Special Requirements where you can enter that information.  

Date *
Date
Date this form is being submitted
Physical Address *
Physical Address
Billing Address *
Billing Address
Please select your company's type of ownership
BANKING & FINANCIAL INFO
Bank Phone Number *
Bank Phone Number
Please provide your company's Federal ID #
Please provide your company's state sales tax number if you are a tax exempt organization
Please provide the number of years your company has been in business
LOCAL TRADE REFERENCES
VEHICLE & PAYMENT INFO
Do you require any of the following on your invoices? (check all that apply) *
Name of person to contact if we have a question regarding your account or an invoice: *
Name of person to contact if we have a question regarding your account or an invoice:
Phone Number of the person you noted above *
Phone Number of the person you noted above
AGREEMENT & GUARANTEE
In submitting this form you agree to the following: As an authorized agent of the business applying for credit (hereinafter "applicant"), I understand that this credit application authorizes Guidry's Oil Company, LLC to check all credit and business associations of applicant. Furthermore, I understand that if applicant is granted credit, the following agreements are made in consideration of that extension of credit: 1) All purchases will be paid for in accordance with the terms of sale; 2) If applicant fails to pay for said purchases when due, the applicant agrees to pay and authorizes the assessment of interest charges of 1.5% per month (18% per annum) on any past due amounts; and 3) In the event that a lawyer or collection agency is used to collect a delinquent account, applicant understands and agrees to pay all collection costs including court cost fines, and reasonable attorney fees.
In submitting this form you agree to the following: In consideration of credit being extended by Guidry's Oil Company, LLC, to the above named applicant the undersigned guarantor hereby contract and guarantee to Guidry's Oil Company, LLC, the faithful payment, when due of all monies owned by the above named applicant. In the event this account is placed for collection in the hands of an attorney, I agree and promise to pay for the cost of collection and reasonable attorney fees.
Today's Date *
Today's Date
This date signifies that I have read and will abide by the Agreement and Personal Guarantee I have electronically signed my name to above

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