Apply for an Alternoil fuel credit card for filling stations throughout Germany

Personal data

First name:

Last name:

Company:

VAT:

Contact person:

Street:

Postal Code:

City:

Phone:

E-Mail:

Email for invoice:

Bank details

Credit institution:

Account number:

Bank sort code:

IBAN:

BIC:

Account holder:

Vehicle list

Vehicle list:

* For a dynamic tank limit (4 day block) leave empty (corresponds to 1,500 litres for business customers and 250 litres for private customers)

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Privacy

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I agree that my contact details may be saved and used for further enquiries.

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Terms and conditions and data protection accepted:

I have read and understood the general terms and conditions as well as the privacy page and agree to them.