You must have authority to bind your business, whether it be a corporation, partnership or LLC, to add or remove drivers authorized to access our Autogas site.

We urge you to check your authority to bind your business if there is any doubt, because by signing and submitting this Change in Authorized Driver Application you are, among other things, personally guaranteeing that you have such authority.

You must agree to advise authorized drivers not to share their PINs and passwords and accept responsibility for their failure to do so or you will not be authorized to access our Autogas site.

All of the additional drivers listed below must have completed appropriate Autogas dispenser training. You must provide us with appropriate, signed certificates for each authorized driver listed below that enables us to verify that training. Drivers who have not completed appropriate Autogas dispenser training or who do not have an appropriate, signed certificate must either: (i) complete internal training provided by you and then provide an appropriate, signed certificate; (ii) complete training provided by an appropriate third party and then provide an appropriate, signed certificate; or (iii) must review our Autogas training materials and successfully complete our Autogas training test. Our training and test are available on our website. No driver will be issued a a PIN or password to access our Autogas site until their training is completed and we have received the appropriate, signed certificate. Click the "+" sign to add additional drivers

The authorized drivers listed below should be removed from the authorized driver user list. We acknowledge and agree that we remain responsible for any past use or continued use of or access to your Autogas site by these drivers.

All Autogas Customers must agree to do business with us pursuant to our Standard Terms and Conditions and Customer Agreement. You may not access our Autogas site without agreeing to the terms of these documents as they may be amended from time to time and in effect.

You acknowledge and agree that typing your name in the signature line below and submitting this form is legally binding and is the same as signing this form by hand under applicable Michigan and federal law.