Your free fuel card in 3 easy steps. 1 Number of cards and VAT-number2 Your data3 Confirmation How many fuel cards do you need?Enter the requested number*Please enter a number from 1 to 1000.Number of cards with km reading*Number of cards with km reading iNumber of cards without km readingNumber of cards without km readingYour VAT numberVAT number*If you only have a company number and no VAT number, you may state this in the box of “remarks” on the next page.Has no vatnumber I have no VAT number Complete the fields below.VAT confirmation*Company name*Street + number*Postal code*City*Country*CountryBelgiumNetherlandsLuxembourgFranceGermanyFirst name contact person*Name contact person*E-mail* Telephone*e.g. 0475232545IBAN* Fuel card invoices are always paid by direct debitBusiness activity*Estimate monthly amount*Estimate of the monthly cost of fuel per cardSelect...Less than € 1.000€ 1.000 to € 3.000More than € 3.000Questions or remarks? (optional)Contact me by telephone Contact me by telephone Terms and conditions* I accept the Terms and conditions and the privacy policy Accept data and may be contacted* I declare that the above information is correct and that I may be contacted about my application. NameThis field is for validation purposes and should be left unchanged. Δ