PostPaid Application Form
Company/Individual Name: (*)
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Postal Address: (*)
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Telephone Number: (*)
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Email-Address: (*)
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New Card:
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Card(s) Amendments:
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User Name: (*)
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Vehicle Registration:
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Product Code(select from List Below): (*)












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Fuel Limit(Kshs) (eg.limit of 10,000 per month)
Monthly? (*)
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Weekly?
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Daily?
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Day Limits(*)
A: Everyday: (*)
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B: Mon- Fri: (*)
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C: Mon- Sat: (*)
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Geographical Restrictions: (*)
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Tank Capicity:
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Mileage Record: (*)
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Driver Code: (*)
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Enter Your M-pesa Transaction Number in case you paid using our Paybill Number:
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Please Use this to Upload the Files Respectivly

Upload Copy of ID:
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Upload Initial Deposit Copy of Kshs.2,000:
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Upload copy of Certificate of Registration:
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Upload copy of VAT Certificate:
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Upload copy of Company PIN:
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