Farmlands Fuel Card Application Form


Farmlands Fuel Card Application Form

Account Holder Details
Required due to AML regulations.
Order Fuel Card
(Please ensure this matches the name on your driver’s licence)
i.e. $400 per day
i.e. $5,000 per month
A randomly generated PIN number will be allocated to your Card and dispatched to you under separate cover. 

You are not authorised on this account.
Please contact the Account authority to complete this request or ask the Account holder to complete the authority form.