Account Holder Details
Farmlands Account Name
Farmlands Account Number
This is found on your Farmlands statement - not on the Farmlands Card
Are you set up as an "Authority" to act on this Account?
Yes
No
No Authority
You are not authorised on this account.
Please contact the Account authority to complete this request or ask the Account holder to complete the
authority form
.
Your Full Name
Phone Number
Email Address
Your Drivers Licence Number
Your Drivers Licence Version Number
Date of Birth
Please enter format DD/MM/YYYY: E.g. 15/08/1974
Your Residential Address
Required due to AML regulations.
Will the card be sent to this address:
Yes
No
Delivery Address
Request
What request would you like to make:
Arrange a new fuel card
Update details on a current fuel card
Order Fuel Card
Details to appear on Card
Card Holder Name
Vehicle Registration
Are the Card Holder details identical to the Account Holder details?
Yes
No
Card Holder Details
Card Holder name
(Please ensure this matches the name on your driver’s licence)
Card Holder email address
Card Holder phone number
Driver's Licence Number
Driver's Licence Version
Address
Date of Birth
Please enter format DD/MM/YYYY: E.g. 15/08/1974
Vehicle Registration
Purchase options
Please select...
All Products
All Products excl Tobacco
Diesel & Oil
Diesel Oil & Ad Blue (DEF)
Diesel Oil & Wash
Diesel Oil Wash & Ad Blue (DEF)
Diesel Only
Fuels & Ad Blue (DEF)
Fuels & Oil
Fuels Oil & Ad Blue (DEF)
Fuels Oil & LPG
Fuels Oil & Wash
Fuels Oil DEF & LPG
Fuels Oil Wash & Ad Blue (DEF)
Fuels Oil Wash & LPG
Fuels Only
Petrol & Oil
Petrol Oil & Wash
Regular & Oil
Default option is "All purchases".
Daily Dollar Limit
Please select...
No Limit
100
150
200
250
300
400
500
600
750
1,000
1,500
2,000
2,500
3,000
3,300
5,000
Default amount is $1,000
Monthly Dollar Limit
Please select...
No Limit
500
1,000
1,500
2,000
2,500
3,000
4,000
5,000
10,000
15,000
20,000
25,000
30,000
50,000
100,000
500,000
Default amount is $5,000
To activate your card you need to choose a 4-digit PIN number when you first use your card.
Change Request
Fuel Card Number
This will be found on the front of your Z fuel card.
Purchase options
Please select...
All Products
All Products excl Tobacco
Diesel & Oil
Diesel Oil & DEF
Diesel Oil & Wash
Diesel Oil Wash & DEF
Diesel Only
Fuels & DEF
Fuels & Oil
Fuels Oil & DEF
Fuels Oil & LPG
Fuels Oil & Wash
Fuels Oil DEF & LPG
Fuels Oil Wash & DEF
Fuels Oil Wash & LPG
Fuels Only
Petrol & Oil
Petrol Oil & Wash
Regular & Oil
Default option is "all purchases". DEF means Diesel Exhaust Fluid (Ad Blue)
Daily Dollar Limit
Please select...
No Limit
100
150
200
250
300
400
500
600
750
1,000
1,500
2,000
2,500
3,000
3,300
5,000
Default amount is $1,000
Monthly Dollar Limit
Please select...
No Limit
500
1,000
1,500
2,000
2,500
3,000
4,000
5,000
10,000
15,000
20,000
25,000
30,000
50,000
100,000
500,000
Default amount is $5,000
Should you wish to Reset your PIN you will need to contact us on 0800 200 600.
I have read the
Z Business Card Terms and Conditions
and agree to abide by them.
I agree
Farmlands Identification Check
I understand that Farmlands may be in touch to confirm identification of applicant and, or cardholder. This process will happen in the next 3 working days, following submission.
Upon clicking submit you will automatically be redirected to our research partner, Yabble, to review Farmlands on this process.
Should you not wish to provide feedback then simply close the window after clicking
Submit Application
and once the confirmation message is displayed.
reCAPTCHA helps prevent automated form spam.
The submit button will be disabled until you complete the CAPTCHA.
Contact Information