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Level Pay Application

Applicant Details

Signature

I have read and agree to the terms listed above and the Davenport Terms and Conditions. I understand and agree that this application is being submitted electronically via the Davenport website at www.davenportenergy.com and that my typed name below shall constitute my signature on this application. My signature indicates that I agree to the Account Terms and Conditions as displayed online and recorded in this document. I understand that I will automatically receive a copy of this electronic application via email upon submission.

YES! Please sign me up as a LevelPay customer! I fully understand and agree to the conditions of the plan outlined above.

Please call me. I wish to have my checking account drafted or pay automatically each month with a major credit card.

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Timestamp

Audit

April 19, 2018 9:32 am EDT

Level Pay Application Uploaded by Tim Davis Davis - tdavis@davenportenergy.com IP 70.182.216.48

July 6, 2018 4:14 pm EDT

Tim Davis - tdavis@davenportenergy.com added by Tim Davis Davis - tdavis@davenportenergy.com as a CC'd Recipient Ip: 70.182.216.48