Tank Ownership Affidavit

First Namee (required)

Last Name (required)

Street Address (required)

City (required)

State (required)

Zip (required)

Phone (required)

Email (required)

Gallon Capacity of Tank (required)

 Tank Above Ground Tank Under Ground

 I authorize Hunt Country Propane, LLC to deliver propane to said propane storage tank(s). I verify I am solely responsible for & own the tank at referenced property. I agree to indemnify and hold harmless, and defend Hunt Country Propane and its employees, officers, and agents from any and all claims related to the filling of my propane tank.