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The eflatbed.com Fuel Card+SM

Fill in the form below for additional information on the eflatbed.com Fuel Card+SM.
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Submitted By:
Name E-mail
Telephone ( ) - ext
Carrier Information:
Carrier Name Contact
Address 1 City
Address 2 State
Zip E-mail
Telephone ( ) - Fax ( ) -
ID Web Site
Fuel Card Questions
1. Who is your current fuel card provider:
EFS Comdata TCH Transplatinum Other None
A. What are the current payment terms?
B. What is the current fuel card funded transaction fee?
C. What is the current fuel card direct bill transaction fee?
D. What are the current express code fees (checks)?
E. Please state the number of fuel card transactions completed per month.
F. Please state the number of express code transactions completed per month.
G. Are you able to receive cash with this card?
2. How many trucks are in your fleet?
3. Type of Carrier:
Local Less than truckload Truckload carrier
4. Are you interested in additional products and services offered by T-Chek? If so, please check the appropriate boxes below.
Phone Card
Funds Distribution (ATMJ, payroll card options, debit card options, etc.)
e-Stop Fuel Information Tool kit (Truckstop and wholesale fuel price information)
Fuel Management Services
Advantage Fuel Network (Free transaction fee paid program)
Regulatory and Compliance Services (Fuel tax services, driver log services, etc)
Software / Technical Questions
1. What operating system are you currently using?
2. What industry software are you currently using?
3. If a software system, which one?
4. Do you process EDI shipments?

5. Do you process payroll and fuel tax in-house?
6. Do you have Internet access?
For additional questions, please call Stacey Schultz at 1.877.767.2435 ext. 3037

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