Keylock Payment Options

Select Payment Choice: Option 1 or Option 2
Choose an Option Below*
- Pre-Authorized Visa, Mastercard.
- Pre-Authorized Debit.
Card Type*
Name on Card*
Card Number*
Date*
I authorize Primemax Energy to use my credit card to process all payments for my propane account.*
- I agree
Attach scan of a Void Cheque*
Accepted file types: jpg, png, pdf, gif.
I authorize Primemax Energy to debit my bank account using the information provided on my void cheque EVERY FRIDAY.*
- I agree
Contact Information
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Customer ID
Email Address*
Sign up for Email Statements.*
- I would like to sign up for email statements
PAYMENT TERMS: COD*
- I agree that the information given above is accurate and complete.

In compliance with the Privacy Act, this information is not distributed to any other party, or used in any other way, except for the purpose stated above. This information is considered private and confidential.

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Keylock Payment Options

Select Payment Choice: Option 1 or Option 2

Contact Information

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