New Customer Registration Form

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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