Customer Credit Application

Customer Information

Account Information

Owner Information

Personal Guarantee Information:

Co-Owner Information

Account Contact Information

Billing Contact (The one who pays the invoices):
Shipping Address  

Sign & Submit Application


CONSENT TO ELECTRONIC RECORDS, ELECTRONIC SIGNATURES AND COMMUNICATION Please read the following important information carefully and retain a copy for future reference. As part of your relationship with us, you have the right to receive certain information “in writing” – which means you are entitled to receive such information on paper. To better serve you, we would like to provide you with this information electronically, but we need your consent to use Electronic Records (defined below) in our relationship with you. This document informs you of your rights when receiving Electronic Records from us in connection with the Multi Service Fuel Card program for which you will apply (“Account”). You must read and consent to the terms outlined below.  Definitions For purposes of this Consent to Electronic Records and Communication, the following terms have the following meaning:  “We,” “us,” and “our” refer to the Multi Service Fuel Card program (operated by Shell MSTS Payments, LLC), Underwriting, Customer Support, and any other person who provides services related to your Account.  “You” and “your” means the person giving this consent, and also each additional applicant, accountholder, authorized user, and account contact on the Multi Service Fuel Card program you apply for.  “Electronic Records” are any legally-required disclosures, terms and conditions, agreements, Account information, notices, statements, and other information provided to you electronically.  Your Consent to Use Electronic Records and Signatures By agreeing to this Consent to Electronic Records, Electronic Signatures and Communication, you acknowledge receipt of this document, consent to the use of Electronic Records and electronic signatures in connection with your account (collectively, “Your Consent”). Your Consent is effective until you withdraw Your Consent. We may always, in our sole discretion, provide you with a document in writing, even when you have chosen to receive it electronically.  Requesting Paper Copies You may request paper copies of Electronic Records at no cost by writing to us at Attn: Customer Service, Multi Service Fuel Card Program, 8595 W 110th St, Overland Park, KS 66210, or emailing us at  Doing Business Electronically Before you decide to do business electronically with us, you should consider whether you have the required hardware and software capabilities described below.  Hardware and Software Requirements To access and retain Electronic Records electronically, you will need to use the computer software and hardware identified below. “Current Version” means a version of the software or hardware that is currently being supported by its publisher. You will need the following: Internet access, Current Version (defined below) of a PDF reader (such as Adobe® Acrobat), Current Version of an Internet browser (such as Internet Explorer, Firefox, Chrome, Safari), A means to retain documents by printing or storing electronically, A valid email address, and A personal computer, mobile device, or other device capable of supporting the requirements listed above.  If these requirements change in a way that creates a material risk that you would not be able to receive or retain your Electronic Records, we will notify you. Continuing to use Electronic Account Services after receiving notice of the change is reaffirmation of Your Consent.  Withdrawing Consent You have the right to withdraw Your Consent at any time and at no cost to you. If you withdraw Your Consent prior to the approval of your application, this will prevent you from receiving credit from us based upon an online application. If at any time you wish to withdraw Your Consent, contact us toll free at 800.876.8584 or write to us at Attn: Customer Service, Multi Service Fuel Card Program, 8595 W 110th St, Overland Park, KS 66210. If you withdraw Your Consent, the legal enforceability of any prior Electronic Record will not change.  YOUR CONSENT TO ELECTRONIC COMMUNICATIONS (“COMMUNICATIONS”) You provide your consent and agree that we may contact you for any lawful reason, including, but not limited to, in connection with your application and Account, including for the collection of amounts owed to us. We may contact you at such addresses or numbers (including wireless cellular telephone numbers and ported landline numbers) as you may provide to us from time to time. We may use any means of communication, including, but not limited to, postal mail, telephone, electronic mail, text messaging, voice messages, or other technology, to reach you.  By providing Your Consent, you Acknowledge that you have the technical ability to access the Electronic Records in the designated formats described above; Acknowledge that you have read the information about Electronic Records, Electronic Signatures and Communication; Consent to having legally-required disclosures, terms and conditions, agreements, Account information, notices, statements, and other information provided or made available to you in electronic form and doing business with us electronically; Acknowledge that you may request a paper copy of an Electronic Record at no charge to you; and Indicate your intent to utilize electronic signatures to apply for credit and process transactions on your account. *


Multi Service Fuel Card Privacy Policy *



Shell MS Fuel Card, LLC. (“Company”) and the party executing the Account Application and these Terms and Conditions (“Cardholder”), hereby agree as follows:


Company is engaged in the business of providing a commercial trucking and fleet purchase program for fuel and other products and services (the “Fuel Card”) as set forth in these Terms and Conditions, including Cardholder’s Application, all Cardholder Purchase Policy(ies), Customer Term Sheet(s), and all applicable Fee Schedule(s) (as they may be amended by Company from time to time) (the “Cardholder Agreement” or “Agreement”). Cardholder requests that Company provide the purchase program and, through its signature(s), use, and/or continued use of such Fuel Card(s), accepts the following terms and conditions governing the use and payment of the Fuel Card, as they may be amended from time to time by Company.

Company is not a seller of merchandise. Company provides credit and billing services only. Company neither sells nor warrants the goods or services obtained from merchants who accept Company’s Fuel Card for payment (“Merchants”). Company’s sole function is to furnish credit and billing services; Company does not warrant any merchandise or services from any source obtained by the use of Company’s credit or billing services. COMPANY HEREBY DISCLAIMS ALL WARRANTIES, EXPRESS OR IMPLIED, RELATING TO ANY SUCH GOODS OR SERVICES, INCLUDING, WITHOUT LIMITATION, ANY WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE OR NON-INFRINGEMENT.


a. Company may, in its sole discretion, extend credit and establish accounts for use by Cardholder. Cardholder represents and agrees that all accounts will only be used for business or commercial purposes and at no time shall any accounts be used for personal, family or household purposes.

b. For the issuance of a line of credit, Cardholder agrees to comply with all Company underwriting requirements. Company’s underwriting process and creditworthiness checks may include, but are not limited to, verifying and reviewing filings with relevant tax authorities, state business filings, carrier 411 and SAFER, business address(es), EIN, and contact information, bank accounts, and obtaining and reviewing credit reports regarding Cardholder, its parent(s), subsidiaries, affiliates, and/or principals.

c. The Company reserves the right to review Cardholder’s account(s) or, as applicable, its principals, parents, subsidiaries and affiliates for verification of financial solvency at any time and if desired, request Cardholder to provide official and finalized supporting financial documents within two (2) business days from the date of the request. All financial statements submitted by Cardholder shall have been prepared consistently year over year and shall be in accordance with the books and records of the Cardholder.

d. Company can reduce or retract Cardholder credit lines in its sole discretion at any time without prior notice and assumes no responsibility or liability for any lost revenue or consequential damages alleged by the Cardholder to be attributable in any way to a credit line retracted or reduced by Company. In the event of a credit retraction or reduction, the Company will use commercially reasonable efforts to notify the Cardholder in advance of reduction or retraction.

e. To secure all of Cardholder’s obligations and liabilities to Company under this Agreement, and all obligations and liabilities of Cardholder to Company under any other document or agreement between Cardholder and Company executed from time to time, the Cardholder hereby grants to Company, if the Company desires, a continuing lien and security interest in all of Cardholder’s accounts, accounts receivable, equipment, inventory, instruments, deposit accounts, chattel paper and all general intangibles. Cardholder agrees that it will not sell or assign any of its accounts or accounts receivable, or any chattel paper or instrument, without the prior written consent of Company which such consent may be conditioned upon, in Company’s sole discretion, any such buyer agreeing to pay directly to Company the amounts to be paid in connection with any such sale or assignment.

     3. PAYMENT

a. Cardholder shall make payments to the Company, or the Company’s designated agent, according to the payment terms provided by Company, as may be amended or altered from time to time in Company’s sole discretion.

b. Cardholder agrees to Electronic Funds Transfer (“EFT”) as the sole method of payment, by authorizing Company to automatically deduct funds from its designated bank account. Any other potential payment method(s) may only be authorized by Company in its sole discretion.

c. Company is authorized to initiate payment on Cardholder’s Billing Date as disclosed in the Customer Term Sheet delivered to Cardholder, and as may be amended from time to time. This authorization is to remain in effect until Company is notified, in writing, of Cardholder’s cancellation of its card(s) and account(s) and all balances due are paid to Company.


a. If any attempted payment by Cardholder is returned unpaid to Company (“Returned Payment”), Cardholder is subject to a Returned Payment administrative fee that shall be 5% of Returned Payment amount. Cardholder is also subject to a $50 Returned Payment bank service fee for each Returned Payment. If Cardholder’s bank or Cardholder for any reason should fail to timely pay any amount due Company, Cardholder understands and agrees that Company may immediately suspend all cards held by Cardholder and draw, levy, or set off any unpaid balance(s) against any letter(s) of credit or other security held by the Company to secure payment of Cardholder’s account(s). Any payments received will be applied first to the past due balance, then to any new purchases.

b. Returned Payments may subject Cardholder’s account(s) to a creditworthiness review by Company and can result in a permanent loss or reduction of Cardholder’s credit line.

c. Cardholder agrees it shall be liable to Company for all costs and expenses incurred by Company in collecting any past due balances and/or enforcing its rights under this Agreement, including but not limited to, late charges, filing fees, court costs, and reasonable attorneys’ fees, if any, incurred by Company to collect all amounts due on Cardholder’s account(s).

d. Past due balances will be assessed a late charge of 1.5% of the total outstanding balance per month.

e. Funds wired to the Company by the Cardholder to reconcile a Returned Payment amount will be applied according to the Company’s payment application schedule.


a. Cardholder will select purchase policies during customer setup. Purchases granted by Merchants, its employees, or agents that vary from Cardholder purchase policies and were not authorized by Company, its employees, or agents will not be paid to Merchant by Company or billed to Cardholder by Company, unless Cardholder approves charges.

b. The Cardholder represents that the purchases under the purchase program are for business or commercial credit only and not for personal, family or household purposes.

c. Cardholder agrees that, for purposes of this Agreement, use of the card(s) provided by Company includes the retention or use of the Account by (i) the Cardholder as named on it, (ii) any person or entity under Cardholder’s direction, authority, or control, and (iii) any Merchant to whom the Cardholder or any person or entity under Cardholder’s direction, authority or control has, at any time provided account information for charging or billing purposes (“Authorized Users”). Cardholder agrees to designate Authorized Users for its account and recognizes that only Authorized Users can make account changes.

d. The Cardholder is liable for any unauthorized use of the card(s) and associated Company products, including InstaMoney® Checks.

e. Cardholder is solely responsible for ensuring the password integrity and security of online access of its account(s), and ensuring passwords and account information are only available to Authorized Users. In the event there is a change in Cardholder’s Authorized Users, the Cardholder is solely responsible for updating passwords and Authorized User information with the Company to ensure its account(s) cannot be accessed by former employees or users who are no longer authorized. Any charges to Cardholder’s account(s) as a result of passwords and Authorized Users not being updated are the sole responsibility of the Cardholder.

f. Cardholder understands the only way to deactivate a Fuel Card associated with its account, so that it can no longer be used to purchase fuel or other authorized items, is through MSFleet or by contacting Company’s Customer Support at (877) 673-5338.

g. Cardholder acknowledges that at no time will an agent of the Company contact the Cardholder and request Cardholder to provide account passwords, banking information, card numbers or any other account information that can be used fraudulently. Any charges incurred by the Cardholder as a result of providing aforementioned account information will be the sole and exclusive responsibility of the Cardholder. Company shall have no liability for losses, claims, or liabilities attributable to Cardholder’s provision of any such information to third parties.

h. Cardholder agrees to have daily transaction and spending limits in place on all cards based on spending needs of drivers. Cardholder agrees to safeguard all cards issued for its account(s), and to secure cards by utilizing identification codes such as Driver IDs, PIN #s, and/or Vehicle IDs. Cardholder further agrees to implement certain Purchase Policies for use of its cards.

i. Any fraudulent charges that result from Cardholder failing to implement the Security Measures outlined in Section 5, item g. of the Cardholder Purchase Policy will remain the sole responsibility of the Cardholder.

j. The Company reserves the right to audit Cardholder purchase controls at its sole discretion and deactivate the Cardholder account if the account is found to not feature proper Security Measures.

     6. FEES

a. Cardholder understands Company may assess certain fees associated with the use and maintenance of Cardholder’s Fuel Card account. All fee schedules agreed to by Cardholder will be provided to Cardholder upon the shipment of the Fuel Cards, and will be reflected in Cardholder’s Customer Term Sheet. All fee charges will be itemized and accounted for in Cardholder invoices.. All fee documentation will be kept on file with the Company for the duration of the Cardholder’s account remaining active with Company. All Cardholder fee schedules that were agreed to during sales process and pre-date these Terms & Conditions remain intact and are consented to by the Cardholder. Cardholder’s use of the card(s) associated with its account shall constitute its acceptance of and agreement to pay all such fees. Cardholder’s continued use of the card(s) associated with its account after being notified of any changes to fees shall constitute its consent to all such changes.

b. In the event Company amends any applicable Cardholder fee schedule due to program changes, the Company will provide the Cardholder written notice of fee changes. Cardholder’s continued use of its Fuel Card(s) shall constitute Cardholder’s assent to, and agreement to pay, any changed fee amounts or revised fee schedules.


Cardholder understands through use of Company’s Fuel Card, it will have access to certain network fuel discounts (“Fuel Discounts”) for purchases at participating Merchant locations. Such Fuel Discounts are offered through agreements between the Merchant and the Company and will be reflected on Cardholder’s billing statement. Cardholder understands any network Fuel Discount is provided based on the agreements negotiated between Company and Merchants, is subject to alteration or expiration in accordance with any agreements between Company and Merchant, and could be discontinued at any time by the Merchant and/or Company. Cardholder understands that should it default in its payment obligation to Company, it may forfeit any Fuel Discount previously owed.


In the event the Cardholder has been awarded a Merchant per gallon fuel discount specific to their account (“Direct Discount”), notwithstanding any billing card platform limitations, the Company will honor the Cardholder Direct Discount for the amount directed by the Merchant and discounted amount will be reflected on Cardholder’s billing statement. Cardholder understands that all Cardholder Direct Discounts are contracted between the Merchant and Cardholder and may be modified pursuant to the terms and conditions offered by the Merchant. Company will accommodate any changes to a Direct Discount requested by a Merchant.


Cardholder agrees it will diligently review each of its billing statements upon receipt for any potential errors or discrepancies. To the extent Cardholder believes it has identified any potential errors or discrepancies, Cardholder must notify Company within thirty (30) days of Cardholder’s receipt of the first billing statement identifying the disputed transaction(s) or alleged billing error(s). Company shall not undertake any review or investigation of, or be responsible or liable for, any transaction or billing disputes more than thirty (30) days after Cardholder’s receipt of the subject billing statement(s). To the extent Cardholder identifies any transaction or billing disputes verified and validated by Company, Company will make commercially reasonable efforts to correct any such disputes prior to the issuance of Cardholder’s next billing statement.


Cardholder shall notify Company promptly of any lost, stolen, or compromised card(s) or to cancel card(s). Cardholder is responsible for all purchases or charges of any kind on any and all lost, stolen, compromised, or cancelled card(s) prior to notification of cancellation to Company by phone at 877-673-5338.


This Agreement may be terminated at any time by either party by giving written notice. Such termination will be effectively immediately upon receipt of the written termination notice by the other party, unless such notice states that termination will be effective at some later date and time. Upon termination, Cardholder agrees to pay the sums due Company according to the above payment procedure. Cardholder agrees to destroy all remaining fuel card and InstaMoney® check inventory. During the term and upon termination of this Agreement, Cardholder shall have the responsibility to pay all amounts incurred or costs associated with Cardholder’s account whenever incurred.


From time to time, services related to Cardholder’s Fuel Card(s) may be inoperative. When this happens, Cardholder may be unable to use its card(s) or obtain information about its card(s). Cardholder should notify Company if it has any problems using its card(s). Cardholder agrees that Company will not be responsible for temporary interruptions in service due to maintenance, website changes, or failures, nor shall Company be liable for extended interruptions due to failures beyond Company’s control, including but not limited to the failure of interconnecting and operating systems, computer viruses, forces of nature, labor disputes and armed conflicts.


Use of any accounts or cards by the Cardholder named on it/them constitutes acceptance of all terms and conditions contained in this Agreement. Any terms and/or conditions in the Agreement may be amended from time to time by Company effective upon no less than 15 days’ prior written notice (and if no effective date is given in such notice, then 15 days from the date of such notice). Use of any card(s) by the Cardholder after notice of any changes or amendments shall constitute Cardholder’s acceptance of such amended terms or conditions. Usage by the Cardholder includes the retention or use of the account(s) by (i) the Cardholder as named on it/them, (ii) any person or entity under Cardholder’s direction or control, and (iii) any merchant to whom the Cardholder or any person or entity under Cardholder’s direction, authority or control has, at any time provided account information for charging or billing purposes.


a. For purposes of this section, “Change of Control” means (1) the sale of all or substantially all the assets of a party; (2) any merger, consolidation or acquisition of a party with, by or into another corporation, entity or person; or (3) any change in the ownership of more than fifty percent (50%) of the voting shares or membership interests of a party in one or more related transactions.

b. In the event of a Change of Control of Company, this Agreement shall be unaffected and shall remain in full force and effect. Company may assign this Agreement in its entirety or transfer any of its rights, interests or obligations in this Agreement to any parent, affiliate, successor, or third party effective immediately upon written notice to Cardholder.

c. Cardholder may not assign this Agreement or transfer any of its rights, interests or obligations under this Agreement to any third party at any time. Any attempt by Cardholder to do so shall immediately be void and ineffective, and Company may immediately terminate this Agreement, retract all credit lines, and cancel all Fuel Cards held by Cardholder in such event.

d. Cardholder agrees to inform Company of any potential Change of Control of Cardholder at least sixty (60) days prior to the effective date of such Change of Control event. Company reserves its right to inquire of any proposed new ownership and/or management of Cardholder, and conduct a renewed underwriting and/or creditworthiness review of Cardholder as contemplated in Section 2 above. Company further reserves its right to retract or reduce any established credit lines, cancel one or more Fuel Card(s) issued by Company, or continue this Agreement with Cardholder’s new ownership or management, in its sole discretion.


This Agreement is governed by the laws of the State of Florida without regard to its principles on the conflict of laws. Cardholder agrees the state or federal courts for Johnson County, Kansas shall be the exclusive venue of any disputes related to this Agreement, and Cardholder further agrees and submits to personal jurisdiction over it of the state and federal courts within the State of Kansas regarding any such disputes. Notwithstanding, Company may, at its sole and exclusive option, choose to pursue legal action against the Cardholder in any state in which the Cardholder does business or where jurisdiction may otherwise be proper.


In the event Cardholder defaults in payment of its obligation to Company, Cardholder irrevocably authorizes Company, at Company’s option, to notify any person or entity providing financing to Cardholder or purchasing any account from Company (each a “Lender/Factor”) of such default and Cardholder hereby irrevocably directs and authorizes any such Lender/Factor to wire directly to Company any funds available to such Lender/Factor as such Lender/Factor funds Cardholder or any funds received by such Lender/Factor as a payment on any accounts purchased by such Lender/Factor from Cardholder, until the balance from Cardholder to Company is paid in full.

I hereby authorize Shell MS Fuel Card, LLC. to obtain credit reports in connection with this Agreement and my application and to obtain credit information from my bank. All financial information submitted in support of this Account Application and Agreement is true and complete in all respects. By signing the Account Application, I certify that I am authorized to make the application and enter into this Agreement on behalf of the entity seeking credit from Company. *

OWNER SIGNATURE (As shown on a Passport and Government-issued ID):

CO-OWNER SIGNATURE (As shown on a Passport and Government-issued ID):

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