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Fill out this quick contact form to get in touch with New England Propane. Need something more specific? Get in touch with us on our general contact form here.

NOTE: If you are having a heat emergency, please call the office immediately. Do not use e-mail to alert us to an emergency. Thank you!











Credit Card Authorization Form - One Time Charge



Date:
To:
Credit Department
New England/Greenwich Propane
162 Grassy Plain Street
Bethel, CT 06801

Please take this authorization to charge my credit card listed below:

Customer Account#:
Name:
Address:
City:
State:
Zip:

Exact Billing Name and Address for Credit Card

Name:
Address:
City:
State:
Zip:
At this time I am requesting a dollar amount of to be charged to this credit card. I am aware that a new form is required for each requested charge and one time charge requests will be processed upon receipt of signed form (same day or next day).

Credit Card # (Mastercard or VISA Only): Enter the last 4 digits of your credit card below and call the office at 203-792-7654 after this submission to give your full credit card number.

Last 4 Digits of Card:
Expires:
CCV Code:
Signature:



Date:

Primary Phone:
Cell Phone:
E-Mail Address: