Newline Oil Co. Ltd.

www.newlineoil.com | sales@newlineoil.com

The Dirr, Murrintown, Co. Wexford Ph: 053 9139177/9139133/9139222

Old Dublin Road, Enniscorthy, Co. Wexford Ph: 053 9237233/9237330 Gorey, 053 9482211

Complete the Application Form and click submit

APPLICATION FORM (fields marked with * are required)

Name*:

Address*:

Home Ph*: Mobile*:

Annual Spend on Oil (approx): House owner or rented

Email address

STANDING ORDER INSTRUCTION

Name/Address of Your Bank/Building Society*:

IBAN NO BIC

Please charge to me/our account No*:

pay Allied Irish Bank, North Main Street, Wexford

(Branch No. 93-33-41) (IBAN IE16 AIBK 9333 4117 1260 79) (BIC AIBKIE2D)

for credit of the account of Newline Oil Co. Ltd. Account No. 17126079

the sum of say Euro,

commencing on and thereafter on each succeeding day of each month until further notice.

Signed: Date:

INSTRUCTIONS TO YOUR BANK OR BUILDING SOCIETY

1. I instruct you to pay standing order from my account at the request of Newline Oil Co. Ltd.
2. The amounts are fixed and will be debited on a fixed date.
3. I understand that Newline Oil Co. Ltd. may change the amounts and dates only after giving me
prior notice.
4. I will inform the bank/building in writing if I wish to change this instruction.
5. I understand that if any standing order is paid which breaks the terms of this instruction the Bank/Building society will make a refund.

For prompt six day delivery service, you can rely on Newline Oil. Est. 1983