Fleetwide Single Fuel Card System – Order Form

CFN Fleetwide – Order Forms

For Fleetwide card requests over 10 cards, please contact us at: cfn@supremeoil.com

"*" indicates required fields

FLEETWIDE SINGLE FUEL CARD SYSTEM - ORDER FORM

ACCOUNT INFORMATION

Account Name #*

Account #*

Date*

Submitted By*

Email*

Phone*

Signature*

CARDS

Card Type*

Light Class

Special Tax

A randomized pin will be generated upon card creation.

Fuel Type*

Unleaded

Midgrade

Premium

Diesel

Dyed Diesel

DEF

Renewable Diesel

Transactions Per Day*

Gallons Per Transaction*

*NOT DOLLAR AMOUNT

Gallons Per Day*

20 Characters & Spaces Maximum

1. Name*

2. Name

3. Name

4. Name

5. Name

6. Name

7. Name

Comments

This field is for validation purposes and should be left unchanged.

CFN Fleetwide – Order Forms