Card Subscription Form

Company Profile

Type of Entity (Tick one)
Nature of Business (Tick one)

Consumption Details & Source of Funding

Source of Funding (Mandatory for Government Accounts only):

Consumption Details & Source of Funding

Account Details and Documents Submitted

Bank Reference


  1. Mandatory Field.
  2. This form is also applicable for vailing the GST invoice. The applicable field must be filled.
  3. 1.50% service charges will be applicable on monthly consumption.


The Fuel Card applicant is requested to kindly read the following before completing this application from on behalf of the organization

  1. By signing below, the Fuel Card applicant acknowledges that he/she on behalf of the Organization, is responsible for the payment of all changes and liabilities billed by Zoom Marketing in the statements of accounts covering  the Fuel Card  issued by Zoom Marketing to the applicant’s organization.
  2. The undersigned/applicant confirms that the information given in this Application Form is complete and accurate, authorizing Zoom to check with credit reporting agencies, credit references and other sources to authenticate and confirm the information disclosed in the Form.
  3. The applicant agrees to abide by the Terms and Conditions set forth in the agreement provided with this application, agrees to observe and be bound by them and any changes or modifications thereto.
  4. The applicant agrees that in case, the outstanding amount is not paid as agreed, Zoom may report the undersigned’s liability for the status of the account to Financial Institutions and others who may lawfully receive such information.

Authorized Signatory 1

For Office Use Only

Cards Finance