Get Petron Fleet Card Application Form

Nn PETRON FLEET CARD Application Form APPLICANT INFORMATION Company Name Business Address Postal Code Billing Address if different from above Telephone Contact Numbers Fax E-mail Address Nature of Business Type of Company Please mark with x Sole Proprietorship Partnership x Corporation Name of Fleet Manager embossed on the card Not to exceed 26 letters 1. Authorized Signature Printed Name Witnessed by Date Designation A P P L I C A T I O N D O C U M E N T S Completely filled-out Application Form Business Profile Latest I. T. R. and Audited F.S. Copy of valid IDs Driver s License PRC card SEC Registration Papers/Articles of etc. Incorporation and By-laws/Mayor s Permit Latest I. T. R./Audited F.S./Proof of Income Secretary s Certificate authorizing Mayor s Permit if any a the Enrollment in Petron Fleet Card Latest billing statement from utility companies b Appointment of Authorized Signatory must be in the applicant s name c Company guaranty for all Petron Fleet Collateral documents if credit is secured Cards issued. Li k e wi s e t h e s ig n a t or y t o t hi s a pp li c a ti o n ac t s in b eh a lf o f t h e A p pli c an t a n d h as f u ll a ut h or i t y t o a p p ly for Petro n F le e t Car d/s a n d i ss u e th e s a me t o the c ard h o l d er s de si g n ate d i n i te m 2 a b ov e a nd t h at the Ap p li c a nt authorizes Petron to make inquiries on any information given on this app lication and agrees to indemnify Petron fr o m a ll c lai ms d e man d s p e n a lt ie s a ct io n s an d pr oc e ed i n gs bro u g ht a g ai ns t th e la tte r or a n y lo s s or da ma g e su ff er ed i n re lat i o n to th e di sc lo s ur e of s ai d i nfor mati o n. T h e App li ca n t ac kn o wle d g es tha t Pe tro n m a y v ar y m od i f y or c h a ng e t h e T er ms a nd C on di t io n s Gov er ni ng t h e Is s u an c e a nd U s e of t h e Pe t r on F le e t Car d fr o m ti me to time. Authorized Signature Printed Name Witnessed by Date Designation A P P L I C A T I O N D O C U M E N T S Completely filled-out Application Form Business Profile Latest I. Do you currently have another Fleet Card Yes No Name if yes 2. Did anyone introduce you to Petron Fleet Card 3. Fees One-time Joining Fee Php5 000 Annual Membership Fee Php300 per card CARDHOLDER INF ORMATION Please use Attachment A for the Cardholder Information AGREEMENT T O T ERMS AND CONDITIONS Th e App lic a nt ap p lies t o Petr o n Cor p or atio n Pe tro n to o pe n a Petr o n F lee t Car d a n d o nc e t his a p p lic ati o n is a ppr ov e d t h e A p p li c an t a gr ee s wit h t h e T er m s a nd C o n di ti o ns Gov er n in g t he Is s u an c e a n d Us e of t h e Pe tr on Fle e t C ar d pr i n t e d her e of. T h e A p pli ca n t war r a nt s t h at a l l i n f or m a ti o n gi v en i n a n y s e cti o n o f t hi s f or m i s tr u e a n d cor r ec t. Li k e wi s e t h e s ig n a t or y t o t hi s a pp li c a ti o n ac t s in b eh a lf o f t h e A p pli c an t a n d h as f u ll a ut h or i t y t o a p p ly for Petro n F le e t Car d/s a n d i ss u e th e s a me t o the c ard h o l d er s de si g n ate d i n i te m 2 a b ov e a nd t h at the Ap p li c a nt authorizes Petron to make inquiries on any information given on this app lication and agrees to indemnify Petron fr o m a ll c lai ms d e man d s p e n a lt ie s a ct io n s an d pr oc e ed i n gs bro u g ht a g ai ns t th e la tte r or a n y lo s s or da ma g e su ff er ed i n re lat i o n to th e di sc lo s ur e of s ai d i nfor mati o n.