Card Maintenance Form - Existing Cards Only
Please return this form to GPO Box 5222 - Melbourne - Vic - 3001
or PH: 1300 130 899
FAX: 1300 665 211
Email: [email protected]
ACCOUNT NUMBER:
ACCOUNT NAME:
PHONE NUMBER:_
QLD - VIC- TAS - NSW - WA -SA
FAX NUMBER:
(PLEASE CIRCLE ONE)
CARD SERVICES REQUIRED Tick each box as required for each card. If no option is selected 'All Services' will default.
Signatures will only be issued for driver specific cards - Odometers will only be issued for vehicle specific cards
All fuel cards will be issued with a PIN. (if your carddoes not have a PIN it will be
replaced with a new card and PIN)
705
705
705
705
705
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705
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Note: If you need to change any embossing on your card, you will need to complete a New Card Form. You will find this card form on our website. www.bp.com.au or please
phone on 1300 130 899. We are unable to process any requests that are incomplete or incorrect.
I/We acknowledge that in making this application that I/We are aware that the use of BP Plus Card/s we are applying for are subject to Terms & Conditions of use.
I/We further acknowledge that a copy of those Terms & Conditions of use is available from BP, GPO Box 5222 Melbourne, Vic 3001
Ph: 1300 130 899 and also on the BP website http://www.bp.com.au
Upon my/our first use of the BP Plus Card, I/We accept the terms and conditions and agree that they will apply to my/our use of the BP Plus Card
I/We acknowledge and agree that the Terms and Conditions of the BP Plus Card may be varied, added to or amended by BP.
Customer Signature
Signatory Name & Title__
(Cards will not be issued without signed approval from customer)
V4 (04/16)
Basic ULP &
LPG (6E)
Diesel Only
(3F)
Diesel &
lubes (3E)
Unleaded
only/lubes
(5E)
Basic ULP &
Premium
ULP/lubes
(2E)
All fuesl only
(1F)
All fuels &
lubes (1E)
All
Fuels/lubes &
services(1C)
Signiture
ODOMETER
Cancel Card
ONLY
Lost/Stolen
Replace
Damanged
Replace
BP Plus Card number: (The full card number MUST be inserted below if it is not then the
card order may be delayed)
Reissue Pin
Change of services only