LNG card | GasNet

GasNet LNG card application

LNG may be purchased only by means of authorized payment using a valid LNG fuel card issued by GasNet, s.r.o.

By filling out and submitting the application form, you apply for the issue of an LNG fuel card and for entry into an LNG Master Purchase Agreement.

Company name

VAT ID

Street address

ZIP Code

Company identification number (in your country)

CIty

Correspondence address

First Name and Surname

Acting based on/as

First Name and Surname

Phone

E-mail

Number of cards

Vehicle brand

Registration number*

Separate each RN with a semicolon

Data box

IBAN

SWIFT/BIC

E-mail for sending invoices

I confirm the data and acknowledge the processing of personal data