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Pilot Credit Card

Welcome Market Safety Solutions Customer to your Fuel Card Application

Gain control of your fleet today by completing the following application and benefit from online account management, security prompt controls and potential savings.

* Required

People

Please include your officers and billing contact information below.

EFT Information

Autodraft is the required method of payment to establish a Fleet Account. Please include your EFT information below.

Fleet Information

Please include your fleet information below

Additional Information

Please include Driver ID and Truck Maintenance information below.

Review

Please review your information below

Sign

Please review the final form and sign

Company Information
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Proprietor, Partners, or Corporate Officers
Billing Contact
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Electronic Funds Transfer Information

Complete the below with your banking information to always stay up to date on invoice payments by using electronic auto-draft.

Customer hereby agrees and acknowledges that: (1) Pilot may withdraw funds from the above-referenced bank account via electronic funds transfer at any time to collect on amounts due and owing Pilot; (2) a $50 processing fee will be debited to Customer’s accounts receivable for each transfer returned to Pilot for non-sufficient funds or for any other reason which would cause the funds to be unavailable for drawing by Pilot; and (3) Pilot will be reimbursed, on demand, by bank wire for the gross amount of each invoice not paid by the electronic transfer of funds in addition to the processing fee described above. This authority is to remain in full force and effect until Pilot and the above-referenced Depository have received written notification from Customer of its termination in such time and in such manner as to afford Pilot and the above-referenced Depository a reasonable opportunity to act on it.

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Fleet and Vehicle Information
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Driver Id

This Driver ID will initially be applied to all of the cards that are requested. To ensure protection of the account, Customer must change the code for each individual card on the Fleet Card Website (www.pilotfleetcard.com) upon receipt of the cards.

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Terms & Conditions" target='_blank' title='Terms and Condition'>terms and conditions.
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