Fuel cards and service station network
Information request form
Name of business:
*
Tax ID number:
Contact person:
*
Street address:
City:
*
Postal code:
Country:
Phone:
*
Fax:
Mobile:
Email:
*
Business activity:
*
Type of transport:
*
Local
Regional
National
International
Nš of company-
owned vehicles:
Trucks, less than 3,5 t.
Trucks, over 3,5 t..
Bus / coach
Vans / minibuses
Cars
Other
Does your company
have a fuel deposit?
Yes
No
Does your company
use other
fuel cards?
Yes
No
Please indicate
which ones:
Are you registered
as a Professional
Diesel oil user
(tax exempt)?
Yes
No
* Required
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