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New Customer Registration Form

If you are an existing customer needing Additional, Replacement or Renewal of Easy Fuel Card, you can login to place request or Contact our
Fleet Manager directly.
If you're a new Customer interested in enrolling for Easy Fuel Card, please fill details in the below mentioned form.
Name of the Company*
 
Contact Person's name*
 
Company Address*
 
State*
 
City*
 
PIN Code  
Landline (STD Code)
 
Phone Number
 
Mobile Number*  +91
 
Email ID*
 
Number Of Vehicles*
Type Of Use
Request For
Request Date
 
All filelds marked with (*) are mandatory