Full Legal Name *

"the Customer"

Company Account Name *

Name of the account

Type of Company *

Type of Business / Industry *

Postal Address *

Post Code *

Physical Address *

Post Code *

Business Phone Number *

Mobile Phone Number *

Business Email Address *

Accounts Email Address *

Accounts Contact Name *

Accounts Phone Number *

Email Invoices / Statements *

Yes No

Invoice Frequency *

Director's Name *

Date of Birth *

Residential Address *

Phone Number *

Upload Photo Identification. E.g. Driver's License or Passport *

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

temp-for-81608-file2-1_

Add another Director? *

Yes No

Director's Name *

Date of Birth *

Residential Address *

Phone Number *

Upload Photo Identification. E.g. Driver's License or Passport *

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

temp-for-81608-file2-2_

Add another Director? *

Yes No

Director's Name *

Date of Birth *

Residential Address *

Phone Number *

Upload Photo Identification. E.g. Driver's License or Passport *

Choose file or drag here

Supported format: JPG, JPEG, PNG, GIF, SVG.

temp-for-81608-file2-3_

Add another Director? *

Yes No

Bank Name *

Bank Branch *

Accountant Name / Company

Accountant Contact Number

Lawyer Name / Company

Lawyer Contact Number

Company Incorporation Number *

Time in Business *

Trade Reference 1 *

Cannot be utilities. E.g. power, phone, banks or finance companies

Phone Number *

Trade Reference 2 *

Cannot be utilities. E.g. power, phone, banks or finance companies

Phone Number *

Trade Reference 3 *

Cannot be utilities. E.g. power, phone, banks or finance companies

Phone Number *

Would you like to apply for a fuel card? *

Yes No

Persons authorised to act on your behalf

To protect your privacy and security we will only discuss your account with authorised personnel whom you have approved to act on your behalf. If the person leaves or you no longer wish them to act on your behalf please contact us immediately to have them removed from your account.

Full Name

Authorised to act on your behalf for the following:

Fuel & Lubricant Deliveries - Ordering, Cancelling, Tracking
Fuel Cards
BPme App
Accounts - All Aspects

Tick all that apply

Add another signatory?

Yes No

Persons authorised to act on your behalf

Full Name

Authorised to act on your behalf for the following:

Fuel & Lubricant Deliveries - Ordering, Cancelling, Tracking
Fuel Cards
BPme App
Accounts - All Aspects

Tick all that apply

Add another signatory?

Yes No

Persons authorised to act on your behalf

Full Name

Authorised to act on your behalf for the following:

Fuel & Lubricant Deliveries - Ordering, Cancelling, Tracking
Fuel Cards
BPme App
Accounts - All Aspects

Tick all that apply

Add another signatory?

Yes No

Complete the Direct Debit Authority

Download Direct Debit Authority Form

Upload the completed Direct Debit Authority Form *

Choose file or drag here

Supported format: PDF only

temp-for-81608-file2-4_

By signing below, you agree to the Personal Guarantee as outlined in McFall Fuel's Terms and Conditions.

View Personal Guarantee

Yes No

27. Personal Guarantee

27.1 In consideration of the Supplier agreeing to extend a credit facility to the Customer and agreeing to supply or continuing to supply the Customer with goods, in the event the Customer is a limited liability company, limited partnership, partnership, trust, incorporated society or any other entity other than an individual person, the undersigned jointly and severally (if more than one) HEREBY GUARANTEE to the Supplier (and its successors and assigns) the due and punctual payment of all moneys due and the performance of all obligations to the Supplier by the Customer and the undersigned agree to pay such moneys and perform such obligations on demand to the Supplier, and as between the (b) Any alteration, modification, variation or Supplier and the undersigned, the undersigned shall be deemed to be principal debtor(s) of the Supplier.

27.2 This guarantee shall be a continuing guarantee to the Supplier for all moneys and all obligations whatsoever owing by the Customer to the Supplier in respect of any goods supplied and shall remain in force until this guarantee is released by the Supplier in writing. This guarantee shall not be discharged by any settlement of account. The liability under this guarantee shall not be discharged, abrogated, prejudiced or affected by:

(a) The granting of time, credit or other indulgence or other concession by the Supplier to the Customer;

(b) Any alteration, modification, variation or addition to any agreement in respect of the supply of any goods;

(c) The liquidation, receivership, administration, bankruptcy, dissolution, compromise or scheme of arrangement, in respect of the Customer;

(d) Any other act, omission or event which but for this provision might operate to discharge, impair or otherwise affect any obligations under this guarantee or any of the rights, powers or remedies conferred by this guarantee or by law.

Full Name

Date

Signature *

Clear

I agree Personal Guarantee *

By signing below, you agree to the Account Application Terms and Conditions as outlined by McFall Fuel Limited.

Full Name

Date

Signature *

Clear

I agree Terms and Conditions *

Thanks for your application!

New Account Application

AdBlue is available under All Purchases, Fuel & Oil, and Diesel & Oil

AdBlue is available under All Purchases, Fuel & Oil, and Diesel & Oil

Persons authorised to act on your behalf

Persons authorised to act on your behalf

Persons authorised to act on your behalf

Complete the Direct Debit Authority

Castrol Hyspin AWS 68 20L NZ