* Indicates Required Information
First Name MI Last Name Suffix
Full Name: * *
(To help the government fight the funding of terrorism and money laundering activities,
federal law requires all financial institutions to obtain, verify, and record information that
identifies each person who opens an account. What this means to you: when you open
an account, we will ask for your name, address, date of birth, and other information that
will allow us to identify you. We may also ask to see your driver’s license or other
identifying documents.)
Month   Day     Year(eg. 1958)
Date of Birth: *
(You must be at least 18 years old to apply. Please Note: Date of Birth is a required field
only to verify your identity. It is not used for credit granting purposes.)
Social Security Number: --*
Primary Phone Number: ()  - * Check here if cell
Secondary Phone Number: ()  - Check here if cell
(If you have entered a cell phone number, or another number that you later convert to a cell
phone number, you agree that we may contact you at this number. You also agree to receive
calls and messages such as, prerecorded messages, calls and messages from automated
dialing systems, or text messages. Normal cell phone charges may apply.)
Email Address: *
(We may use your email address to contact you about your account. We may also use your
email address to send you information about products and services you might find useful.)
Annual Income: *     (Whole dollars only)
(Federal law requires that we collect income information to determine your ability to pay.
Alimony, child support or separate maintenance need not be revealed if you do not wish it to be
considered as a basis for repaying this obligation.)
Home Ownership:   *
Mailing Address:   *
* * *     (City, State, Zip)
    Is your mailing address the same as your physical address?   
The Address on your Driver's License is:
Driver's License Number:
Driver's License State:
 
Would you like to designate an Additional User on your account?    
(The Additional User may assist with the administration of your account and this credit card account may
also appear on the Additional User's credit file.)
You may only designate one Additional User. However, you may add other cardholders to your Account.
Would you like to add other cardholders?      
  Please tell us how you heard about Gulf Oil  
I have read and agree to the Retail Installment Credit Agreement and Privacy Information.
I have read and acknowledge this Important Information.

Please wait while we process your application...