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05 September 2010
 
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Fuelcard Application Online



1. Enter Company Details (Fields marked by an asterisk (*) are required)
An Existing Customer?
Company Name (*)  
Trading Name *If Different
Company Address (*)  
Select County (*)  
Website   
Company Registration Number /or VAT Number
Number of Years Trading  
Type of Business
2. Your details (Fields marked by an asterisk (*) are required)
  
Position in company (*)  
Contact Name (*)  
Phone Number (*)  
Email (*)    
  
  3. Trade References (Fields marked by an asterisk (*) are required)
Please supply the following details of 2 Trade References:
  
Refrence 1 Details Refrence 2 Details
Trading Name (*)    Trading Name(*)   
Trading Address (*)    Trading Address(*)   
Contact Name (*)    Contact Name (*)   
Contact tel No (*)    Contact tel No (*)   
 


Registered in Ireland at Clonminam Industrial Estate, Portlaoise, Laois, Ireland. Emo Oil Limited - Directors: D. Murphy, F. O'Dwyer, G. Wilson,
S. Doyle Registered No. 118120