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  Limited company application

*denotes required fields 		 


Card(s) Required*
Fuelogic Keyfuels Diesel Card
Texaco Fuel Card
Uk Fuels Fuel Card
Company Name*
Address*
Post Code*

Registered Address
(If different to above)
Post Code

Main contact name*
Telephone (Landline)*
Fax
Mobile
Email*

Company registration number
VAT registration number
Number of years trading*
   
Business Information  
Main business description
Operational details. (Please state names of
2 directors / personnel responsible for daily operations and running of company.)
   
Email address for invoices*
Current Supplier(s)
Do you purchase bulk fuel?*
Number of Cars / Vans
Number of HGV
Monthly Diesel cost (£)*

Other products used
AdBlue
Lubricants
Anti-Freeze
   
Vehicle card details  
Name to be embossed on Card*
ie. Company Name (Max. 28 Characters)
Mileage recordings required?*
Do you require Online Account Management? (Please tick if you DO NOT require this service)
Number of cards required*
   
Please enter vehicle registration no. or drivers names required on cards.
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Account details  
Chosen account password*
Price notification option (Fridays)* Via SMS Text or Email
   



To process your application the following must be completed

By ticking below you expressly agree that we have your consent and the consent of any other employee, director, officer or agent whose personal information you may have given to use your / their personal information for such purpose. Any personal information given in our application process will be used to manage your account. It may be necessary to pass on the personal information to our agents or other reputable third party to enable us to provide you or your business with our fuel and other services. For example, we may pass the information to a credit reference agency or credit insurer or other credit management solution providers where a search may be conducted on the information so that an approved credit facility may be considered for you / your business.
 

 
 
 
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