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    Section 1: Type of Application

    Station State: (Optional - Please select if you are being referred by any BHPetrol station.)

    Station Referral: (Required if station state has been selected.)
    Station Referral: (Required if station state has been selected.)
    Station Referral: (Required if station state has been selected.)
    Station Referral: (Required if station state has been selected.)
    Station Referral: (Required if station state has been selected.)
    Station Referral: (Required if station state has been selected.)
    Station Referral: (Required if station state has been selected.)
    Station Referral: (Required if station state has been selected.)
    Station Referral: (Required if station state has been selected.)
    Station Referral: (Required if station state has been selected.)
    Station Referral: (Required if station state has been selected.)
    Station Referral: (Required if station state has been selected.)

     

    Upload Documents:

    Latest Audited Account,
    Bank statements from the last 3 months,
    Latest Form 9 & 49 submissions,
    Most recent SSM report
    Director’s NRIC photocopy (in colour),
    Business Registration Certificate (SSM),
    Income Tax Return Acknowledgment,
    Bank statements from the last 3 months
    Latest Audited Account,
    Bank statements from the last 3 months,
    Latest Form 9 & 49 submissions,
    Most recent SSM report,
    SKDS Approval Letter
    Director’s NRIC photocopy (in colour),
    Business Registration Certificate (SSM),
    Income Tax Return Acknowledgment,
    Bank statements from last 3 months,
    SKDS Approval Letter
    Latest Form 9 & 49 submissions,
    Most recent SSM report
    Director’s NRIC photocopy (in colour),
    Business Registration Certificate (SSM)
    Latest Form 9 & 49 submissions,
    Most recent SSM report,
    SKDS Approval Letter
    Director’s NRIC photocopy (in colour),
    Business Registration Certificate (SSM),
    SKDS Approval Letter
    Director’s NRIC photocopy,
    Business Registration Certificate (SSM),
    SKDS Approval Letter
    Form 9 & Form 49,
    1st page of Bank statement
    Business Registration Certificate (SSM),
    1st page of Bank statement
    Form 9 & Form 49,
    1st page of Bank statement,
    SKDS Approval Letter
    Business Registration Certificate (SSM),
    1st page of Bank statement,
    SKDS Approval Letter
    Form 9 & Form 49
    Business Registration Certificate (SSM)
    Form 9 & 49,
    SKDS Approval Letter
    Business Registration Certificate (SSM),
    SKDS Approval Letter

     

    Section 2: Type of Loyalty Card (eCard)

    *For companies who is currently holding Physical Corporate eCard and wish to continue with the same.

    *For assigning a vehicle to physical eCard, please see Section 6 of this form.

    This card will be issued for the vehicles detailed in Section 6. It can be used together with your X-Fleet card during payment to accumulate reward points (ePoints).

    Principal eCard will be issued for the company’s Managing Director/Owner as specified in Section 4b of this form. All ePoints earned by supplementary eCards will be accumulated under the principal eCard holder. Only the principal eCard holder is authorized for points redemption.

    Applicable for X-Fleet Card & X-Fleet Diesel Subsidy Card holders.

    No physical eCard will be issued.

    Reward points (ePoints) are automatically credited for each transaction made with any X-Fleet or X-Fleet Diesel account.

    Accrued ePoints can be used to offset amounts on your monthly X-Fleet statement.

    Note: Any existing Physical Corporate eCard will be converted to Virtual eCard - our team will be in contact with you for confirmation.

     

    Section 3: Company Details

    Company Name:

    Company Registration No.:

    Managing Director / Owner’s Name:

    Correspondence Address:

    Postcode:

    City:

    State:

    Billing Address: (to specify only if it’s different from Correspondence Address)

    Postcode:

    City:

    State:

    Office Telephone Number:

    Facsimile (if any):

    Nature of Business:

    Date of Incorporation:

    Estimated Monthly Petrol Consumption (litre):

    Estimated Monthly Diesel Consumption (litre):

    Current Fuel / Fleet Card Account (if any):

     

    Section 4: Authorized / Contact Personnel

    a: Contact personnel for X-Fleet Card / Cash Card

    Department:

    Accounts Department

    Salutation:

    Name:

    Mobile Phone No.:

    E-mail Address:

    Card Administrator

    Salutation:

    Name:

    Mobile Phone No.:

    E-mail Address:

    b: Authorized Principal eCard holder
    Managing Director / Owner’s Details

    Salutation:

    Name:

    NRIC/Passport No.:

    Mobile Phone No.:

    E-mail Address:

    Please attach a copy of Director’s NRIC photocopy (in colour)

     

    Section 5: X-Fleet Web Portal / Mobile App Access

    Within 24 hours upon approval of your X-Fleet account, activation email with a temporary password for first-time login to the BHPetrol X-Fleet Web Portal/Mobile App will be sent to the registered email address.

    Please specify the authorized person to be granted with the first access:

    Salutation:

    Name:

    Mobile Phone No.:

    E-mail Address:

     

    Section 6: Card Information

    Please download the X-Fleet Card Application Form, then fill up the form and upload the file with the button below:
    1. For each card, you may specify the type of products that can be purchased. Once a card is approved, you can update these product restrictions via BHPetrol X-Fleet Web Portal. Note that updating restrictions requires the existing card to be cancelled and a new one to be issued). You may submit request for additional card at any time via BHPetrol X-Fleet Web Portal.
    2. If you have selected for “Physical eCard” in Section 2, please ensure that you specify which vehicle each eCard is for
    3. The Credit Limit for your account is determined as follows:-
      1. Post-paid: The account’s credit limit is determined based on the review of your application.
      2. Pre-paid: The account’s credit limit matches the prepaid amount deposited into the account.

      You can set specific spending limits for each card as follows:

      Transaction Limit: The maximum limit allowed for each transaction using the card.

      Daily Limit: The total maximum allowed for all transactions in a day.

      Monthly Limit: The total maximum allowed for all transactions in a single month.

      (Transaction Limit < Daily Limit < Monthly Limit)

    Note: If you need to provide information for more cards, feel free to make additional copies of this page.

    Upon approval, your card(s) will be despatched to the address you have provided for correspondence address. Please expect delivery within 3-5 working days.

     

    Section 7: Declaration

    I/We hereby declare that I/We shall inform BHPetrol should I/We become involved in any activity that may infringe the Anti-Money Laundering, Anti-Terrorism Financing and Proceeds of Unlawful Activities (AMLA).
    I/We hereby undertake to inform BHPetrol if I/we am/are identified as a politically exposed person (PEP) and/or I/we and/or my/our immediate family members (parents, spouses and children) and/or close associates are related to any PEP.

    I/We expressly consent to and authorize BHPetrol to disclose and report to Bank Negara Malaysia, if any of my/our cash transactions exceed Ringgit Malaysia Twenty-Five Thousand (RM25,000-00) only, at any time and without liability, any information and particulars (financial or otherwise) relating to my/our affairs and accounts, financing and conduct thereof for such purposes as BHPetrol deems fit or appropriate.

    Transaction limits declaration

    The transaction limits, including daily and monthly restrictions, indicated in this application form are provided as estimates or indicative limits only. BHPetrol reserves the right to adjust, change, alter and/or revise these figures to the nearest Ringgit Malaysia limit based on the data available in BHPetrol’s fleet card system. BHPetrol shall not bear any responsibility for any loss or damage whatsoever incurred due to any discrepancies between the control limit as recorded in BHPetrol’s fleet card system and those specified in this application form.

    Verification consent

    I/We accept and confirm that Boustead Petroleum Marketing Sdn Bhd (“BHPetrol”) reserves the right to decline my/our application without the obligation to provide any reason(s) hereto. I/We hereby give irrevocable and unconditional consent for BHPetrol to conduct a credit background check in connection with my application. This process is crucial for verifying the financial integrity and integrity of applicants, ensuring legal and financial security for both parties.

    Should my/our application be approved by BPetrol, I/We accept and confirm that upon signing the BHPetrol X-Fleet/Cash Card or utilizing the card, I/We shall be bound by the terms and conditions governing the use of the BHPetrol X-Fleet/Cash Card and BHPetrol eCard Loyalty Programme as outlined in the BHPetrol X-Fleet/cash Card Member Agreement which will be provided to me/us alongside with the BHPetrol X-Fleet/Cash Card.

    Consent to processing of personal data

    By providing my/our personal information and signing below, I/We explicitly consent to the processing of my/our personal data in accordance with the Boustead Petroleum Marketing Sdn Bhd (“BHPetrol”) Personal Data Protection Notice (“Privacy Notice”) accessible at https://www.bhpetrol.com.my/privacy-policy/. This includes the use my/our personal data for targeted marketing and advertising efforts, aimed at delivering information about relevant benefits, promotions products and services offered by BHPetrol or its strategic partners. I/We understand that this consent includes the right to opt out of receiving such communications at any time, ensuring my/our control over personal data usage.

    I/We explicitly authorize BHPetrol to act on my/our behalf in applying for any applicable government diesel subsidies could provide. I/We agree to furnish additional information promptly that may be required to facilitate this process.

    Information accuracy

    I/We hereby declare that all personal and financial information provided to BHPetrol in my/our card application and throughout the membership is accurate, complete and up to-date. I/We commit to promptly notify BHPetrol of any changes to my/our information to ensure continued accuracy and security.

    Please download the declaration form and sign with company stamp and upload the file with the button below:

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