Business Account Application | MyAuto Advantage

BUSINESS DETAILS

Create New Account

Your Email Address *

Password *

Password

Confirm Password

Trading As: (PLEASE TICK) *

Name of Entity: (Must match ABN registry exactly) *

ABN/ACN of company/business: *

Trading Name: *

How Many Cards Applying For: *

Fuel Spend Per Month: *

Postal Address: *

Address Line 1

City

State / Province / Region

Postal Code

Country

Street Address: *

Address Line 1

City

State / Province / Region

Postal Code

Country

Work Number: *

Fax Number: *

Contact Person: *

Mobile Number: Contact Person *

Email Address: *

Title: *

TYPE OF BUSINESS

Nature of Business: *

Industry Type: *

Date Commenced: *

Number of Employees: *

DETAILS OF SOLE TRADER / PARTNERS / DIRECTORS / TRUSTEES

1. Full name of Proprietor / Partner / Director / Signatory:

Title *

Mr
Ms
Mrs

Date of Birth *

Residential Address: Not P.O. Box *

Drivers License No: *

State *

2. Full name of Proprietor / Partner / Director / Signatory:

Title

Mr
Ms
Mrs

Date of Birth

Residential Address: Not P.O. Box

Drivers License No

State

SIGNATURE & CONSENT

On behalf of the business nominated in this Business Application, I/we being the duly authorized officer(s) have read & agreed to accept the terms and conditions as attached to this application. I/we warrant that the information provided by me/us in this application is true and complete. I/we authorise any person or organization to provide Business Fuel Cards Pty Ltd (Trading as Fleet Card) with such information as may be required.

Signatory’s full name *

Title (Business Only) *

Signature *

Date Signed *

Joint applicant full name (1)

Signature

Date Signed

Joint applicant full name (2)

Signature

Date Signed

Preferred Payment Cycle: *Direct Debit Only *

Weekly
Fortnightly
Monthly

Terms and Conditions

Authority to apply

* I confirm that I am authorised to apply for an account with Business Fuel Cards Pty Limited on behalf of the entity in this application.

Declaration / Privacy Act

* I warrant that the information provided by or on behalf of the entity in this application is correct and authorise any person or organisation to provide Business Fuel Cards Pty Limited with such information as may be required to establish their credit worthiness. Information provided above is specifically identified in the application process and can be referenced if the applicant wants to check accuracy.

Acceptance
* I have read and accept Business Fuel Cards Pty Limited Terms and Conditions

I have read and agree to the Terms and Conditions