1602 HOUSTON HWY. VICTORIA, TEXAS 77901 361-573-6554 PROPANE 361-576-1479 U-HAUL
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Kellogg PROPANE INC.
1602 Houston Hwy.
Victoria, Texas 77901
(361) 573-6554
Residential Commercial
Customer ____________________________________________________________________________________________
Tank Location______________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
Tank Serial #_____________________________________Tank Size___________________________________________
Tank Manufacturer____________________________________________________________________________________
This Agreement allows Kellogg Propane Inc. to take all necessary action to collect for debts incurred by customer for propane or work provided, according to the Uniform Credit Code in the State of Texas. Customer states that he/she owns the above listed tank and has the right to place this lien upon the tank.
Failure to pay debts to Kellogg Propane Inc. as agreed will cause Kellogg Propane Inc. to take possession of the above said tank.
Customer Signature___________________________________________________________________________________
Kellogg Propane Inc. __________________________________________________________________________________
Thank you
Keith A. Ethridge
President