Platform Fuels Authorization Form

Get Prequalified Now for Propane Payment Plan Terms

Please submit a few details so that we can get you prequalified for propane payment plan terms. We will match you with the possible offerings without affecting your credit score! Our software uses our Soft Credit Check Prequalification technology to match you to the best possible payment offers we have.

First Name *

Middle Name

Last Name *

Address *

Apt/Suite/Other

City *

State *

Zip *

Social Security *

Date of Birth *

Phone *

Email *

Do you own or rent? *

check_box You understand that by clicking Submit immediately following this notice, you are providing 'written instructions' under the Fair Credit Reporting Act, authorizing Platform Fuel Distribution Holdings LLC to obtain information from your personal credit profile and other information from Equifax, TransUnion, and/or Experian to conduct a pre-qualification for credit. This process will not affect my credit score.

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I certify I have read and agree to the Electronic Disclosures communications here.