Kelly's Propane Service Application

Please provide the following contact information:

Name
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
County
Home Phone
FAX
E-mail

Do you currently own the propane tank and equipment at your location?

Yes No Not Sure Not Applicable

Do you Own or Rent your home?

Own Rent Other

Is this for a new construction?

Yes No

Do you currently have propane service with another Company?

Yes No Used to, but not now.

Do you want/have an Above Ground Tank, or an Underground Tank? (please note, underground tanks are for purchase only)

Above Ground Underground Not Sure

Please tell us what uses (or will be using) propane at your location.

Furnace          Stove/Oven       Space Heater     Water Heater   
Clothes Dryer    Refrigerator     Propane Lights   Power Generator
Grain Dryer      Pool Heater      Out-Door Grill   Other          

PLEASE NOTE:

With any new install, where a propane line will need trenched in, please contact OUPS and have your underground utility lines marked (if any). This is extremely important. OUPS will mark underground main electric lines, telephone lines, ECT. The job may have to be postponed if they are not marked by your set date. OUPS (Ohio Utilities Protection Service) can be contacted by calling them toll free at 1-800-362-2764. They must be contacted no later then 48hrs prior to the tank set date. For more information, you can visit their website by clicking HERE . If you need help with this, or have any questions, just let us know in the text box below.

Please tell us any other information you want to include, or enter any questions that you have in the box below. There is no text limit on this box, so please feel free to include anything you wish. When you are finished, please click the Submit Form button.