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Thank you for your interest in becoming a Daniels Propane customer. Generations of Connecticut families have come to depend on Daniels' outstanding service. Please assist us in determining the right service for you by filling out this simple online form. Information indicated in • red is required.

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I hereby state that the information I have provided above is true and accurate to the best of my knowledge. I am requesting propane delivery service from Daniels Propane, LLC., and agree to provide appropriate information to implement Daniels Propane service.

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8 High Street, P.O. Box 32, Portland, CT 06480 Phone: 877-PRO-GAS1 (776-4271), 860-342-1200, Fax: 860-342-4203 CT License S1-302857