Propane/Fuels Request

Please make a selection or entry in each field so that we may best service you.

1) Type of Service Requested

If you are requesting propane, please answer numbers 2, 3 and 4. If you are NOT requesting propane, please move to #5.

2) Gallons of Propane Needed

If you selected "User Specified" above in #2, please specify how many gallons you are requesting. Otherwise, leave #3 blank. If this is not a propane request, please leave #3 blank.

3) Specify Propane Gallons

If this is a propane request, please answer #4 with how many gallons are currently in your tank. If this is not a propane request, please leave #4 blank.

4) Propane Currently in Tank

If this is a fuels request, please answer numbers 5, 6 and 7. If you are not requesting fuels, please leave numbers 5,6 and 7 blank.

5) Gallons of Fuels Needed

If you selected "User Specified" above in #5, please specify how many fuels gallons you are requesting. Otherwise, leave #6 blank. If this is not a fuels request, please leave #6 blank.

6) Specified Fuels Needed (Gallons)

If this is a fuels request, please answer #7 with how many gallons are currently in your tank. If this is not a fuels request, please leave #7 blank.

7) Current Fuels Volume

8) Special Delivery Instructions

9) Type of Payment

10) Name (First, Last, Suffix)

Company

11) Address

Address 2

City and State

Postal Code

Phone Number

Account Number

Crystal Flash Office Location

truck

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PLEASE NOTE: Do not use this form if you need EMERGENCY FUELS OR PROPANE DELIVERY

Call your local Crystal Flash office if you need an emergency fuels delivery. Click here for a phone number for your local office.

Crystal Flash will make every effort to fulfill online fuel oil delivery orders within one week of receipt of the order.

Thank You for your business.

Please contact our Corporate Office for information regarding products and services available outside the Michigan area.