ORDER FORM FOR LEGAL ENTITIES

(Street, City, Postcode)
(Street, City, Postcode)
Name, surname:*
Name, surname:*
E-mail
Type of card:* Debit Credit
Desired 45 days credit limit (EUR):
Quantity of fuel per month (liters):*
 Take it from cards funn lt system (free) By post (2 EUR be PVM)
 yes (2 EUR + VAT) No
Company name, which is seen on cards, maximum 25 symbols:*

Card identifying data (name, surname, car state number or any other information, maximum 25 symbols)* Limit liters/day Limit EUR/day Limit liters/month Limit EUR/month Possibilities of settlement* Cards are valid in Lithuania Service on working days only
   
   
   
   
   
   
   
   
   
Please specify, if You need more cards and present additional list of cards ordered:  Yes
(Position, Name, Surname)

*Please fill in the starred areas

Ši svetainė naudoja slapukus, kad galėtumėme Jums suteikti aukščiausio lygio paslaugas, pritaikytas individualiems poreikiams

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